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. 2025 Jan 7;10(5):260-262.
doi: 10.1016/j.vgie.2025.01.002. eCollection 2025 May.

EUS-guided gastroenterostomy for treatment of afferent limb syndrome

Hyun Jae Kim  1   2 , Nicholas Holt  1   2 , Roberto Trasolini  1   2
Affiliations

EUS-guided gastroenterostomy for treatment of afferent limb syndrome

Hyun Jae Kim et al. VideoGIE. .
No abstract available

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Conflict of interest statement

All authors disclosed no financial relationships.

Figures

Figure 1
Figure 1
Computed tomography shows dilated afferent limb (6 cm, white arrow) along with a large enterolith (red arrow) just proximal to the stenosis.
Figure 2
Figure 2
Endoluminal therapies performed for afferent limb syndrome include enterolith removal and endoluminal plastic stent placement. A, Large enterolith proximal to the stenosis was almost obstructing the lumen. B, Stone retrieval basket was used to fragment and remove the enterolith. C, Guidewire was used to place 2 double-pigtail plastic stents across the stenosis site.
Figure 3
Figure 3
Identification of the afferent limb could be performed by tracking the common bile duct to the hepaticojejunostomy. The common bile duct can be distinguished from intrahepatic vasculatures as an anechoic structure using Doppler (white arrow; red arrow shows vascular structure).
Figure 4
Figure 4
EUS-guided transluminal drainage. A, EUS assessment demonstrates dilated afferent limb (5.2 cm). B, Distal phalange of the electrocautery-assisted lumen-apposing metal stent is deployed within the dilated afferent limb on EUS. C, Endoscopic view of the proximal phalange of a fully deployed lumen-apposing metal stent is shown with good drainage of bilioenteric fluids into the stomach.
Figure 5
Figure 5
Computed tomography scan postgastroenterostomy shows well-positioned lumen-apposing metal stent (white arrow) with decompressed afferent limb and pneumobilia (red arrow).
See this image and copyright information in PMC

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References

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