Double Over-The-Scope Clip (OTSC) Closure Following Lumen-Apposing Metal Stent (LAMS) Dislodgement Allows Single-Session Eus-Directed Transgastric Ercp (EDGE)

A Roux-en-Y gastric bypass patient underwent EDGE for choledocholithiasis. A 20-mm LAMS was placed from jejunum into remnant stomach and balloon-dilated. Following through-the-LAMS passage, duodenoscope angulation at the pylorus resulted in peritoneal dislodgment of the proximal flange. The jejunal perforation was OTSC closed. A repeat EDGE access was obtained more proximally with another gastro-gastric 20-mm LAMS. This second LAMS access was used to sequentially remove the first dislodged LAMS from the remnant stomach, OTSC close the gastric perforation, and perform through-the-LAMS ERCP with sphincterotomy and bile-duct clearance, uneventfully. Angulation determines dislodgment during EDGE. OTSC closure permits single-session EDGE despite dislodgment.

Citation: Sanchez-Ocana R, Fuentes Valenzuela E, de Benito Sanz M et al. OP62V DOUBLE OVER-THE-SCOPE CLIP (OTSC) CLOSURE FOLLOWING LUMEN-APPOSING METAL STENT (LAMS) DISLODGEMENT ALLOWS SINGLE-SESSION EUS-DIRECTED TRANSGASTRIC ERCP (EDGE). Endoscopy 2021; 53: S26.

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Artikel online veröffentlicht:
19. März 2021