Managing LAMS misdeployment: challenges and solutions in EUS-Guided Biliary Drainage

Abstract Text We present the case of a 61-year-old woman with obstructive jaundice due to pancreatic adenocarcinoma infiltrating the papillary region, send for an EUS-guided biliary drainage with choledocoduodenostomy. During the procedure, we observed LAMS misdeployment into the duodenal wall. Since the fistulous tract appeared to be maintained, we performed a salvage therapy by cannulating the common bile duct through the fistula and placing a fully covered metal stent, restoring the choledocoduodenostomy. Procedure was delivered with the same linear echoendoscope and was successful, with patient discharged promptly; the consensual reduction of bilirubin levels allowed the start of chemotherapy. This case highlights how biliopancreatic endoscopists should have adequate experience in both EUS and ERCP, to effectively manage even complex situations avoiding the need for more invasive interventions.

Video  http://data.process.y-congress.com/ScientificProcess/Data//106/570/1428/fe299a3b-569a-4ad2-9703-d2cb14a2d195/Uploads/16849_Video_LAMS%20misdeployment%20ESGE.mp4

Publication History

Article published online:
27 March 2025