Figure 1. (A) Endoscopic view of large LSG staple line defect that is in open communication with peritoneal cavity with pus, a drainage tube was seen in situ. Note healthy gastric mucosa (B) Total closure of the LSG staple line defect with OverstitchTM endoscopic suturing system (C) Stent fixation with OverstitchTM Endoscopic Suturing System (D) UGI shows no contrast extravasation, and black arrow points at the location of the endoscopic suture placement.
Case Description/Methods: A 57-year-old man with a history of decompensated liver cirrhosis complicated by esophageal varices presented with multiple episodes of hematemesis. He denied diarrhea or bloody stool. As per outside records, his most recent EGD 7 months prior was notable for bleeding esophageal varices requiring 3 band ligations. Patient was tachycardic on presentation. Initial labs showed
Figure 1. A) Endoscopic Images of Transoral Gastric Outlet Revision with APC of the gastrojejunal anastomsis followed by purse string full thickness suturing over a 10 mm CRE balloon. B) EUS image of demonstrating distal phalange deployment of LAMS into the remnant stomach for EUS guided transgastric ERCP. B. Weight chart demonstrating weight loss after RYGB and regain with TORe and LAMS placement.
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