Endoscopic ultrasound-directed transgastric ERCP in patients with Roux-en-Y gastric bypass using lumen-apposing metal stents or duodenal self-expandable metal stents. A European single-center experience

Rev Esp Enferm Dig. 2020 Mar;112(3):211-215. doi: 10.17235/reed.2020.6897/2020.

Abstract

Introduction: endoscopic ultrasound-directed transgastric ERCP is emerging in Roux-en-Y gastric bypass.

Methods: a review of 14 consecutive patients.

Results: fourteen EUS-directed gastro-gastrostomy/gastro-jejunostomy were performed using lumen-apposing metal stents or duodenal self-expandable metal stents. Single-session ERCP was successful in 9/12 cases and deferred procedures or follow-up in 6/7 cases. Papillary access was obtained in all cases. Dislodgment occurred in 4/19 patients and was handled successfully endoscopically. Transgastric stents were removed after a median of 30 days. No recurrence/fistula were noted after a median of 256 days post-removal.

Conclusions: duodenal self-expandable and lumen-apposing metal stents can be used for single-deferred endoscopic ultrasound-directed transgastric ERCP in Roux-en-Y gastric bypass.

Publication types

  • Review

MeSH terms

  • Cholangiopancreatography, Endoscopic Retrograde
  • Endosonography
  • Gastric Bypass*
  • Gastrostomy
  • Humans
  • Stents