Work

EUS-assisted gastric outlet remodeling in a patient with refractory gastrojejunal anastamotic stricture

Year: 2025

Type: article

Abstract: Background and Aims: Gastrojejunal (GJ) anastomotic strictures occur in up to 30% of patients with Roux-en-Y gastric bypass. The majority of such patients require endoscopic therapy, and many will require revisional surgery after endoscopic therapy fails. We present a novel stepwise approach for definitive endoscopic management of refractory GJ strictures. Methods: A 56-year-old female with prior balloon dilatation and lumen-apposing metal stent (LAMS) placement underwent EUS-guided gastric outlet remodeling (EUS-GOR). Two LAMSs were placed in parallel, 1 across the native GJ anastomosis and 1 from the pouch into the afferent limb. After maturation of the intervening tissue tract and prophylactic suturing, a septotomy was performed using wire-guided traction. Results: at 12 months. Conclusions: EUS-GOR is a feasible and minimally invasive option for carefully selected patients with a refractory GJ anastomotic stricture.

Source: VideoGIE

DOI: 10.1016/j.vgie.2025.06.002

Authors: Kambiz Kadkhodayan, Saurabh Chandan, Sagar Pathak, Abdullah Abbasi, Muhammad K. Hasan, Shayan Irani

Institutions: AdventHealth Orlando, Virginia Mason Medical Center

Language: English

Topic: Bariatric Surgery and Outcomes

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000