Different challenging scenarios for EUS-guided gastro-jejunostomy misdeployment and how to deal with it

Abstract Text -Gastric perforation with free jejunal perforation: a guidewire was passed into the jejunum under fluoroscopy control. Thanks to a gastroscope over-the-wire, the location of the distal flange of the LAMS was subsequently identified in the peritoneum. A 16.5mm dilation of LAMS was performed to pass through and, after identifying the jejunal perforation, which was catheterized by our guidewire, a second dilation of the jejunal perforation was done in order to facilitate de passage to a new LAMS 20 x 10mm placement by stent-in-stent.

-Gastric perforation without free jejunal perforation: after misdeployment of LAMS distal flange in the peritoneum, a guidewire was passed. A jejunal perforation using a forward viewing endoscope with an ERCP precut knife was performed, and a new 20x10mm LAMS was passed into jejunal limb without previous dilation, and deployed as stent-in-stent technique.

Video http://data.process.y-congress.com/ScientificProcess/Data//106/570/1428/8d9f83dd-7142-4042-84a0-aa3a350b0fed/Uploads/16849_GJ_misdeployment.mp4

Publication History

Article published online:
27 March 2025