Login to your account
Don’t have an account?
Create a Free AccountAnatomy - Small intestine
EUS-directed transgastric ERCP in Roux-en-Y gastric bypass revision of sleeve gastrectomy
EUS-directed transgastric ERCP (EDGE) is an effective approach for the treatment of biliary adverse events of patients who have undergone Roux-en-Y gastric bypass (RYGB).1 Through deployment of a lumen-apposing metal stent (LAMS) from the gastric pouch into the excluded stomach, EDGE allows access to the bypassed stomach and duodenum in patients who have undergone RYGB (Fig. 1). However, patients who have undergone sleeve gastrectomy (SG) who undergo revision to RYGB have limited working space within both the gastric pouch and excluded stomach (Fig. 2), making therapeutic endoscopic procedures such as EDGE technically challenging.Switching the switch: endoscopic reversal of a biliopancreatic diversion
Biliopancreatic diversion (also known as duodenal switch) is a complex bariatric surgery that includes a sleeve gastrectomy and long Roux-en-Y intestinal bypass. The entero-enteric anastomosis is very distal, resulting in bypass of two-thirds or more of the intestine. Patients lose weight not only because nutrients bypass most of the intestine, thereby reducing the absorption area, but also because nutrients join the biliopancreatic secretions and enzymes distally, leading to reduced digestion and absorption.Lumen-apposing metal stent for the management of intramural hematoma of the GI tract
GI intramural hematomas are uncommon and usually occur in the esophagus or the duodenum, and in rare cases they occur in the stomach.1 The most common cause is blunt abdominal trauma; other causes include endoscopic interventions, peptic ulcer disease, and pancreatitis; in very rare cases they can occur spontaneously in patients receiving oral anticoagulants.2,3 We present the management of 2 cases of gastric and duodenal intramural hematomas by the use of lumen-apposing metal stents (LAMSs).
Copyright © 2023 Elsevier Inc. except certain content provided by third parties. The content on this site is intended for healthcare professionals.
