Off label use of lumen-apposing metal stent for persistent gastro-jejunal anastomotic stricture  

作　　者：Muhammad Sohail Mansoor Juan Tejada Nour A Parsa Eric Yoon Sven Hida 

机构地区：[1]Department of Gastroenterology, Albany Medical Center

出　　处：《World Journal of Gastrointestinal Endoscopy》2018年第6期117-120,共4页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：We are reporting a novel "off-label" use of lumen apposing metal stent(LAMS) for management of refractory gastro-jejunal(GJ) anastomotic stricture after Roux-en-y gastric bypass(RYGB). With increasing prevalence of obesity, bariatric surgery is performed more frequently than ever. RYGB is one of the most commonly performed bariatric procedures. GJ anastomotic stricture is a late complication of this procedure. Our patient, seven years after RYGB developed GJ anastomotic ulcer and subsequently a stricture not amendable to repeated pneumatic dilations. Instead of using the conventional fully covered self-expanding metal stent(fc SEMS) we deployed the relatively new LAMS keeping in mind its novel dumbbell shaped design. Our patient's symptoms were controlled successfully and she remained asymptomatic on follow-up. Despite initial approval for pancreatic pseudocyst drainage, LAMS has been used with increased frequency at various locations within gastrointestinal tract including GJ anastomotic strictures. Future randomized control trials are warranted to compare the efficacy of fcSEMS to LAMS.We are reporting a novel "off-label" use of lumen apposing metal stent(LAMS) for management of refractory gastro-jejunal(GJ) anastomotic stricture after Roux-en-y gastric bypass(RYGB). With increasing prevalence of obesity, bariatric surgery is performed more frequently than ever. RYGB is one of the most commonly performed bariatric procedures. GJ anastomotic stricture is a late complication of this procedure. Our patient, seven years after RYGB developed GJ anastomotic ulcer and subsequently a stricture not amendable to repeated pneumatic dilations. Instead of using the conventional fully covered self-expanding metal stent(fc SEMS) we deployed the relatively new LAMS keeping in mind its novel dumbbell shaped design. Our patient's symptoms were controlled successfully and she remained asymptomatic on follow-up. Despite initial approval for pancreatic pseudocyst drainage, LAMS has been used with increased frequency at various locations within gastrointestinal tract including GJ anastomotic strictures. Future randomized control trials are warranted to compare the efficacy of fcSEMS to LAMS.

关 键 词：Gastro-jejunal anastomotic STRICTURE LUMEN apposing metal stent DYSPHAGIA ROUX-EN-Y gastric BYPASS 

分 类 号：R[医药卫生]