Novel EUS-guided gastrojejunostomy technique using a new double-balloon enteric tube and lumen-apposing metal stent (with videos).
BACKGROUND
Surgical gastrojejunostomy is associated with relatively high morbidity and mortality rates. However, current experimental EUS-guided gastrojejunostomy information is limited.


OBJECTIVE
To evaluate a novel EUS-guided gastrojejunostomy technique using a new enteric balloon and lumen-apposing metal stent.


METHODS
Animal experiment.


METHODS
Animal laboratory at a referral center.


METHODS
In 5 pigs, gastrojejunostomies were created under EUS guidance. Fully covered lumen-apposing stents were placed between the stomach and the jejunum.


METHODS
Technical success and adverse events of EUS-guided gastrojejunostomy.


RESULTS
All stents, with 1 exception, were successfully deployed without any adverse events. The mean time to stent placement was 44.2 minutes (range 28-64 minutes). All animals showed normal eating behavior without signs of infection for 1 month after the procedure. Endoscopic imaging of the stomach site showed the stent to be patent and stable, without dislodgment, in all of the pigs. Necropsy showed complete adhesion between the stomach and the jejunum wall.


CONCLUSIONS
Pilot study.


CONCLUSIONS
Creation of an EUS-guided gastrojejunostomy by using a novel enteric balloon and metal stent appears to be promising as a minimally invasive treatment.
Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Takao
T
Itoi
Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Fumihide
F
Itokawa
Division of Research and Development for Minimally Invasive Treatment, Cancer Center, School of Medicine, Keio University, Tokyo, Japan.
Toshio
T
Uraoka
Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Takuji
T
Gotoda
Division of Research and Development for Minimally Invasive Treatment, Cancer Center, School of Medicine, Keio University, Tokyo, Japan.
Joichiro
J
Horii
Division of Research and Development for Minimally Invasive Treatment, Cancer Center, School of Medicine, Keio University, Tokyo, Japan.
Osamu
O
Goto
Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Fuminori
F
Moriyasu
Department of Gastroenterology, Soon Chun Hyang University School of Medicine, Seoul, Korea.
Jong Ho
JH
Moon
Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
Yuko
Y
Kitagawa
Division of Research and Development for Minimally Invasive Treatment, Cancer Center, School of Medicine, Keio University, Tokyo, Japan.
Naohisa
N
Yahagi
D000818:Animals; D019160:Endosonography; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D015607:Stents / Q000009:adverse effects; D013552:Swine; D018084:Ultrasonography, Interventional
SEMS; self-expandable metal stent