Dados do Trabalho

Título

Endoscopic ultrasonography-guided double-balloon-occluded gastrojejunostomy bypass (EPASS) for malignant gastric outlet obstruction

Resumo

Female patient, 58 years-old, being followed-up for ulcerative colitis. The patient evolved with the presence of a pancreatic nodule on follow-up tomography. Undergoing endoscopic ultrasound with puncture and diagnosis of pancreatic head adenocarcinoma.
She evolved with jaundice and acute cholangitis, being submitted to biliary drainage by ERCP.
One month later, the disease progressed with duodenal invasion and obstructive symptoms. Endoscopic palliation of obstructive symptoms was opted with endoscopic ultrasonography-guided double-balloon-occluded gastrojejunostomy bypass (EPASS).
Patient presented good resolution of obstructive symptoms during follow-up, referred for continuation of chemotherapy.
Surgical gastrojejunostomy (GJ), which has been the standard palliative treatment for malignant gastric outlet obstruction (MGOO), is associated with good functional outcome and the long-term relief of symptoms. Endoscopic placement of a metal stent for MGOO treatment has been gaining popularity as an alternative to surgical GJ because of its high technical success rates and less invasiveness.
In conclusion, we established the feasibility of an EUS-GJ technique using a unique double-balloon tube and a novel electrocautery tipped stent delivery system equipped with a LAMS.

Palavras-Chave

EUS; EPASS; Endoscopy;