EUS-Guided Endoscopic Gastrointestinal Anastomosis with Lumen-Apposing Metal Stent: Feasibility, Safety, and Efficacy

Stuart K. Amateau, Chin Hong Lim, Nicholas M. McDonald, Mustafa Arain, Sayeed Ikramuddin, Daniel B. Leslie

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Traditionally, restoration of normal bowel continuity after resection and bypass of a diseased or obstructed gastrointestinal tract can only be achieved through surgery, which can be technically challenging and comes with a risk of adverse events. Here, we describe our institutions’ experience with endoscopic-guided gastroenterostomy or enteroenterostomy with lumen-apposing metal stent (LAMS) from March 2015 to August 2016. Ten patients had gastrogastrostomy (gastric pouch to gastric remnant) and three patients had jejunogastrostomy (Roux limb to gastric remnant) for the reversal of Roux-en-Y bariatric surgery. One patient had gastroduodenostomy (stomach to duodenal bulb) post antrectomy and one patient had jejunojejunostomy for distal obstruction following Roux-en-Y reconstruction. Technical and clinical success were achieved in all patients, save for delayed anastomotic stenosis following stent removal in one patient, with a mean follow-up of 126 days (3–318 days) with minimal complications in two patients. Endoscopic gastrointestinal anastomosis therefore may be a safe and feasible technique to re-establish continuity of the digestive system following bypass in the short-term.

Original languageEnglish (US)
Pages (from-to)1445-1451
Number of pages7
JournalObesity Surgery
Volume28
Issue number5
DOIs
StatePublished - May 1 2018

Bibliographical note

Funding Information:
Dr. Ikramuddin serves as an advisory board member for Novo Nordisk, USGI, and Medica; consults for Medamodix; receives grant support from Medtronic, Enteromedics, and ReShape Medical; and receives consulting income from Enteromedics. The relationship has been reviewed and managed by the University of Minnesota in accordance with its conflict of interest policies.

Funding Information:
Dr. Amateau serves as a consultant for Boston Scientific Corporation, the current manufacturer of the lumen-apposing metal stent used in this study. It is the only one currently available in the USA and they have no influence on his scientific endeavors. Dr. Lim has nothing to disclose. Dr. McDonald has nothing to disclose. Dr. Arain received personal fees from Boston Scientific during the conduct of the study. Dr. Ikramuddin serves as an advisory board member for Novo Nordisk, USGI, and Medica; consults for Medamodix; receives grant support from Medtronic, Enteromedics, and ReShape Medical; and receives consulting income from Enteromedics. The relationship has been reviewed and managed by the University of Minnesota in accordance with its conflict of interest policies. Dr. Leslie serves as a consultant for Medtronic unrelated to the submitted work.

Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Digestive system abnormalities
  • Intestinal fistula
  • Intestinal obstruction
  • Intestines
  • Malabsorption syndromes

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