Novel Use of a Uniquely Designed, Lumen-Apposing, Metal Stent in Benign Gastric Outlet Obstruction in Two Patients

Pinson, Ross; Pathirana, Induruwa; Magulick, John; Domanski, Jeremy; Okoh, Emuejevoke; Womeldorph, Craig

doi:10.14309/crj.2017.20

Cited by 12 publications

(17 citation statements)

References 10 publications

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“…Diagnosis is usually made with imaging and confirmed via endoscopy. A total of 138 patients were reviewed in the 4 retrospective studies and 13 case reports [13][14][15][16][17][18][19][20][21][22][23][24]. The patients were predominantly female, with ages ranging from 18-86 years.…”

Section: Discussionmentioning

confidence: 99%

“…To date, 20 patients in the reviewed literature had a LAMS placed to treat a gastric stricture [14][15][16][17][18][19][20]. The etiology of the strictures included anastomotic strictures, caustic injury, peptic ulcer disease with resultant peptic stricture formation, pyloric stenosis and 1 case of malignant pyloric stenosis (Fig.…”

Section: Gastric Stricturesmentioning

confidence: 99%

“…The authors speculated that the bleeding was due to unintentional mucosal injury when the catheter delivery system was advanced across the stricture. The other 2 patients had symptom resolution and showed endoscopic evidence of stricture improvement after a median of 100 days of follow up A total of 5 additional case reports were reviewed in the literature regarding a LAMS used to treat a gastric stricture [17][18][19][20]. In all the case reports, no adverse events were reported.…”

Section: Gastric Stricturesmentioning

confidence: 99%

“…To date, 36 patients in the reviewed literature had a LAMS used to treat a small bowel or a gastrojejunal (GJ) stricture [14][15][16][17][20][21][22]. Etiology for small-bowel strictures included peptic ulcer-associated stricture and chronic pancreatitis-associated stricture.…”

Section: Duodenal and Gastrojejunal Stricturesmentioning

confidence: 99%

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Lumen-apposing metal stents for gastrointestinal luminal strictures: current use and future directions

Larson¹

2019

aog

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The management of short-segment benign gastrointestinal (GI) strictures refractory to currently available endoscopic treatments (endoscopic balloon dilation, intralesional steroid injection, incisional therapy and fully covered self-expanding metal stents) proves to be challenging. Lumenapposing metal stents (LAMS), originally developed for access to and drainage of pancreatic fluid collections, are being used in an off-label manner for the treatment of short GI luminal strictures. The short length and wide flanges make LAMS potentially suitable for this indication and may reduce complications and improve patient tolerance. In this article we review the published literature, including 138 patients from 4 retrospective studies and 13 case reports who received a LAMS for the treatment of a short GI luminal stricture. In the reviewed literature only 2 of the 138 cases had immediate adverse events warranting hospitalization: perforation and postoperative GI bleed. A total adverse event rate of 32.5% (45 of 138 cases) was reported. Migration was the most common adverse event, accounting for 40% of the total. Nearly 58% of reported patients had symptom and stricture resolution after stent removal in the reviewed studies. Follow up varied from 28-352 days after stent removal. Although more data are needed to determine their long-term safety and efficacy, LAMS represent an important alternative to traditional endoscopic options when approaching patients with short GI luminal strictures.

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Section: Discussionmentioning

confidence: 99%

Section: Gastric Stricturesmentioning

confidence: 99%

Section: Gastric Stricturesmentioning

confidence: 99%

Section: Duodenal and Gastrojejunal Stricturesmentioning

confidence: 99%

See 2 more Smart Citations

Lumen-apposing metal stents for gastrointestinal luminal strictures: current use and future directions

Larson¹

2019

aog

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“…I N TOTAL, 19 studies and case reports were identified and included in the review [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] (Table 1 and Fig. S1).…”

Section: Literature Reviewmentioning

confidence: 99%

What is the ideal indwelling time for metal stents after endoscopic ultrasound‐guided gastrojejunostomy? Case report of delayed iatrogenic perforation with a review of the literature

Taïbi

Fontanier

Derbal

et al. 2020

Digestive Endoscopy

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Several recent studies have described the feasibility, efficacy and safety of the placement of lumen‐apposing metal stents (LAMS) for the treatment of gastrointestinal strictures. However, the optimum stent indwelling time is unclear. We reviewed the literature on endoscopic gastroenterostomy (GE) with a focus on the stent indwelling time and we described the first reported case of iatrogenic perforation six months after Axios stent placement. In the literature review (n = 239), the composite technical success rate and clinical success rate were 93.7% and 87.9%, respectively. The mean follow‐up period was 191 days, and the mean stent indwelling time was 88 days. Among 13 studies (n = 202), the mean rate of complications was 13.4%. The principal complication was mis‐deployment of the stent (4.5%). We report a case report of delayed iatrogenic perforation. A 59‐year‐old male patient with cystic dystrophy of the duodenum has been followed for several years. He presented with anorexia following duodenal obstruction and underwent endoscopic ultrasound‐guided gastrojejunostomy. Six months later, he was referred to our center due to septic shock, and abdominal computed tomography revealed peritonitis secondary to a perforation of the small intestine, opposite the Axios stent. The mean LAMS indwelling time after GE was 88 days. To minimise the rate of adverse events, such as ulceration and mucosal overgrowth, regular abdominal computed tomography and endoscopy can be performed to evaluate the local effect of the stent. When the disease has resolved, the LAMS must be removed as soon as possible.

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Lumen Apposition: A Changing Landscape in Therapeutic Endoscopy

McCarty

Thompson

2022

Dig Dis Sci

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Novel Use of a Uniquely Designed, Lumen-Apposing, Metal Stent in Benign Gastric Outlet Obstruction in Two Patients

Cited by 12 publications

References 10 publications

Lumen-apposing metal stents for gastrointestinal luminal strictures: current use and future directions

Lumen-apposing metal stents for gastrointestinal luminal strictures: current use and future directions

What is the ideal indwelling time for metal stents after endoscopic ultrasound‐guided gastrojejunostomy? Case report of delayed iatrogenic perforation with a review of the literature

Lumen Apposition: A Changing Landscape in Therapeutic Endoscopy

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