ASGE DDW Videos from Around the World | 2026-ENDOSCOPIC J-POUCH RECONSTRUCTION TO ELIMINATE CANDY CANE SYNDROME IN A PATIENT WITH TOTAL GASTRECTOMY AND ROUX-Y ESOPHAGOJEJUNOSTOMY

ENDOSCOPIC J-POUCH RECONSTRUCTION TO ELIMINATE CANDY CANE SYNDROME IN A PATIENT WITH TOTAL GASTRECTOMY AND ROUX-Y ESOPHAGOJEJUNOSTOMY

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Video Transcription

Video Summary

This case describes a 58-year-old woman with severe Candy Cane Syndrome after total gastrectomy, causing vomiting, regurgitation, pain, and weight loss. Prior endoscopic treatments failed, and surgery was high-risk. The team used an innovative endoscopic approach: placing LAMS to fuse the septum between limbs, then performing septotomy and removing the stents to create an endoscopic J-pouch. They sutured non-fused areas to prevent leak or bleeding. Follow-up showed improved anatomy, weight gain, and restored ability to eat solids, liquids, and pills. The authors conclude this technique may safely relieve obstruction and improve quality of life when surgery is risky.

Asset Subtitle

S.N. Stavropoulos, S. Askarian, R. J. Modayil, P Srivastava, D.R. Nemakayala, H. Saljooki

Keywords

Candy Cane Syndrome

total gastrectomy

endoscopic J-pouch

LAMS septotomy

gastrointestinal obstruction