ASGE DDW Videos from Around the World | 2022-EUS GUIDED GASTROJEJUNOSTOMY AND CHOLEDOCHODUODENOSTOMY WITH LUMEN APPOSING METAL STENTS: AN EFFICIENT APPROACH TO DOUBLE ENDOSCOPIC BYPASS

EUS GUIDED GASTROJEJUNOSTOMY AND CHOLEDOCHODUODENOSTOMY WITH LUMEN APPOSING METAL STENTS: AN EFFICIENT APPROACH TO DOUBLE ENDOSCOPIC BYPASS

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Video Transcription

Video Summary

In this video, a case of concomitant malignant gastric outlet obstruction and biliary obstruction in an eight-year-old female with metastatic pancreatic cancer is presented. Traditional endoscopic stinting is difficult to manage, so double endoscopic bypass is used. The technique involves inserting a wire across the obstruction into the small bowel and then placing a nasobiliary drain over the wire. A lumen opposing metallic stint is inserted with catheter assistance for both gastrogyneostomy and choledicodydenostomy. The procedure, which took 36 minutes, was successful, and the patient was discharged six days later. The video concludes that larger studies are needed to determine the safety and efficacy of this double endoscopic bypass technique. (No credits were mentioned in the transcript)

Keywords

malignant gastric outlet obstruction

biliary obstruction

metastatic pancreatic cancer

double endoscopic bypass

lumen opposing metallic stint