Synergistic use of endoscopic sutures and stents for managing complex upper gastrointestinal disorders

Q3 Medicine

VideoGIE Pub Date : 2026-06-01 Epub Date: 2026-02-03 DOI:10.1016/j.vgie.2026.01.005

Kambiz Kadkhodayan MD , Shayan Irani MD

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引用次数: 0

Abstract

Background and Aims

Endoscopic sutures and stents are essential tools in therapeutic endoscopy, each serving distinct roles. When used synergistically, they enable innovative solutions for managing complex solutions in the management of complex GI conditions.

Methods

Seven patients underwent endoscopic procedures that included the simultaneous use of endoscopic stents and sutures. Clinical scenarios included (1) a benign duodenal apex stricture treated with a lumen-apposing metal stent (LAMS) anchored via traction sutures; (2) duodenal perforation in a Roux-en-Y gastric bypass, treated with a sutured gastrogastric (GG) LAMS, and a concomitant through-the-scope duodenal fully covered self-expandable metal stent (SEMS), also secured via sutures; (3) closure of a GG fistula after LAMS removal, using a HeliX Tacking System (Boston Scientific, Marlborough, Mass, USA); (4) malignant duodenal obstruction of an uncovered stent, treated with a sutured fully covered SEMS; (5) suturing 2 side-by-side LAMSs for added stability; (6) HeliX tack to secure a LAMS before EUS-directed transgastric ERCP; and (7) suturing and closure of the proximal end of a LAMS to prevent solid debris entry.

Results

Technical success was achieved in all cases without significant adverse events.

Conclusions

We demonstrate the synergistic use of endoscopic sutures and stents to expand therapeutic options for patients with complex GI conditions.

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内镜缝合线和支架的协同应用治疗复杂的上消化道疾病

背景和目的内镜缝合线和支架是内镜治疗中必不可少的工具，各有其独特的作用。当协同使用时，它们为管理复杂胃肠道疾病的复杂解决方案提供了创新的解决方案。方法7例患者行内镜手术，包括同时使用内镜支架和缝合线。临床场景包括(1)良性十二指肠尖狭窄，通过牵引缝线锚定腔位金属支架（LAMS）治疗；(2) Roux-en-Y胃旁路术中的十二指肠穿孔，使用缝合的胃（GG） LAMS治疗，并同时使用经内镜的十二指肠全覆盖自膨胀金属支架（SEMS），也通过缝线固定；(3)使用HeliX固定系统（Boston Scientific, Marlborough, Mass， USA）关闭LAMS移除后的GG瘘管；(4)未覆盖支架的恶性十二指肠梗阻，采用缝合的全覆盖SEMS治疗；(5)缝合2个并排的lams，增加稳定性；(6)在eus引导的经胃ERCP前，螺旋钉固定LAMS；以及(7)缝合和关闭LAMS的近端以防止固体碎屑进入。结果所有病例均获得技术成功，无明显不良事件发生。结论：我们展示了内镜缝合和支架的协同使用，以扩大复杂胃肠道疾病患者的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.