Self-expandable metal stent in lumen apposing metal stent (the SEMS-in-LAMS technique) as salvage procedure for LAMS misdeployment during endoscopic ultrasound-guided gallbladder drainage

Abstract Text An 86-yo-man underwent endoscopic ultrasound-guided gallbladder (GB) drainage for acute cholecystitis. During the examination, challenges raised due to the distance between GB and gastro-duodenal wall. Drainage was performed under ultrasound and radiological guidance, via transgastric route, using an electrocautery-enhanced lumen apposing metal stent and the free-hand technique. A guidewire was advanced after GB access with the hot catheter. Misdeployment of the proximal flange occurred, with the flange fully released in the gastric wall. Therefore, a fully covered self-expandable metal stent was placed over the wire through the LAMS, with distal end in the GB and proximal end in stomach, obtaining cholecystogastrostomy and drainage of purulent bile; no contrast medium leakage was seen at control. Proximal SEMS end was anchored to the gastric wall with two clips [1] [2].

Video http://data.process.y-congress.com/ScientificProcess/Data//106/570/1428/06e87eb5-935f-4802-aa9e-5754f87a4f72/Uploads/16849_AA.mp4

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

• 1 Armellini E, Metelli F, Anderloni A, Cominardi A, Aragona G, Marini M, Pace F.. Lumen-apposing-metal stent misdeployment in endoscopic ultrasound-guided drainages: A systematic review focusing on issues and rescue management. World J Gastroenterol 2023; 29 (21): 3341-3361 PMID: 37377584. PMID: PMC10292149
• 2 Lera ME, Matuguma SE, Madruga-Neto AC, Brunaldi VO, Minata MK, Guedes HG, de Moura EGH.. Self-expandable metal stent in lumen-apposing metal stent (the SEMS-in-LAMS procedure): a simple salvage procedure after LAMS misplacement. Endoscopy 2019; 51 (4): E77-E78 Epub 2019 Jan 23. PMID: 30674045