Outcomes of endoscopic retrograde cholangiopancreatography performed via a lumen-apposing gastroenterostomy stent: a multicenter observational study (with videos).

BACKGROUND AND AIMS: We describe our multicenter experience with endoscopic retrograde cholangiopancreatography (ERCP) performed via a lumen-apposing metal stent (LAMS) for the management of coincident gastric outlet obstruction (GOO) and biliary obstruction.

METHODS

Patients with GOO and biliary obstruction who underwent EUS guided gastroenterostomy (EUS-GE) with a LAMS and ERCP via the LAMS at 3 hospitals from June 2016 to March 2025 were included. Baseline variables, interventions, outcomes, and adverse events (AEs) were characterized using descriptive statistics.

RESULTS

We included 30 patients. EUS-GEs were performed with 15-mm (n = 17, 57%) and 20-mm LAMSs (n = 13, 43%). The median time between EUS-GE and ERCP was 39 days. Technical success was achieved in 27 patients (90%). The most common intervention was biliary stent insertion or exchange (n = 26, 87%). There were 4 (13%) AEs (bleeding and LAMS dislodgement).

CONCLUSIONS

ERCP performed via a gastroenteric LAMS is a safe and effective option for the management of coincident GOO and biliary obstruction.