Salvage endoscopic ultrasound-guided gastrojejunostomy as a bridge to definitive surgical therapy for duodenal adenocarcinoma presenting with duodenal stent obstruction

Clin J Gastroenterol. 2023 Jun;16(3):387-391. doi: 10.1007/s12328-023-01781-2. Epub 2023 Apr 8.

Abstract

The utilization of endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) in the setting of an obstructed (ingrown) duodenal stent as a bridge to pancreaticoduodenectomy (PD) remains undescribed. Herein, we report a case study of a 51-year-old patient who underwent EUS-GJ using lumen apposing metal stent (LAMS) for an obstructed duodenal stent during neoadjuvant treatment for duodenal adenocarcinoma. The patient ultimately underwent surgical resection by a classic PD 14 weeks after LAMS placement. EUS-GJ using LAMS represents a potential option as a salvage bridge to surgery for duodenal obstruction in the setting of an obstructed duodenal stent.

Keywords: Endoscopic ultrasound; Gastric outlet obstruction; Gastrojejunostomy; Lumen-apposing metal stent; Whipple procedure.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma* / complications
  • Adenocarcinoma* / diagnostic imaging
  • Adenocarcinoma* / surgery
  • Duodenal Neoplasms* / complications
  • Duodenal Neoplasms* / diagnostic imaging
  • Duodenal Neoplasms* / surgery
  • Duodenal Obstruction* / diagnostic imaging
  • Duodenal Obstruction* / etiology
  • Duodenal Obstruction* / surgery
  • Gastric Bypass*
  • Humans
  • Middle Aged
  • Stents
  • Ultrasonography, Interventional