VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025
Endoscopic anastomotic reconstruction with lumen-apposing metal stents.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Thushyanthan Andrew, Schauer Cameron, Robertson Jason, Van Rijnsoever Marius
Аннотация
BACKGROUND AND AIMS: This case is a presentation on the use of lumen-apposing metal stents (LAMSs) and then endoscopic dissection to permanently re-establish continuity between the gastric pouch and remnant in a complex and hostile abdomen.
METHODS: A 56-year-old man with a previous Roux-en-Y gastric bypass, performed for weight loss, developed life-threatening gastric injury, including perforation after chronic consumption of nonsteroidal anti-inflammatory drugs. He underwent multiple operations, finally resulting in a gastrostomy, and his gastric remnant and pouch were closed. Subsequently, he was reliant solely on parenteral feeding. After multidisciplinary discussion, a 3-step endoscopic procedure was used to reconnect the gastric pouch and remnant. In the first 2 steps, LAMSs were used to create a fistula and establish a connection between the pouch and remnant, facilitating a liquid diet. Endoscopic dissection was later undertaken to dissect the bridge between the 2 stents, which were subsequently removed, and endoscopic suturing was used to ensure the connection between the previously divided stomach.
RESULTS: There were no significant immediate or delayed adverse events of the procedure. The patient is now able to tolerate both a liquid and soft diet.
CONCLUSIONS: This case demonstrates the novel and successful endoscopic management to permanently reverse a Roux-en-Y gastric bypass as a result of adverse events.
METHODS: A 56-year-old man with a previous Roux-en-Y gastric bypass, performed for weight loss, developed life-threatening gastric injury, including perforation after chronic consumption of nonsteroidal anti-inflammatory drugs. He underwent multiple operations, finally resulting in a gastrostomy, and his gastric remnant and pouch were closed. Subsequently, he was reliant solely on parenteral feeding. After multidisciplinary discussion, a 3-step endoscopic procedure was used to reconnect the gastric pouch and remnant. In the first 2 steps, LAMSs were used to create a fistula and establish a connection between the pouch and remnant, facilitating a liquid diet. Endoscopic dissection was later undertaken to dissect the bridge between the 2 stents, which were subsequently removed, and endoscopic suturing was used to ensure the connection between the previously divided stomach.
RESULTS: There were no significant immediate or delayed adverse events of the procedure. The patient is now able to tolerate both a liquid and soft diet.
CONCLUSIONS: This case demonstrates the novel and successful endoscopic management to permanently reverse a Roux-en-Y gastric bypass as a result of adverse events.