{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T11:37:42Z","timestamp":1778672262371,"version":"3.51.4"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Surgical gastrojejunostomy (S-GJ) is standard treatment for gastric outlet obstruction (GOO), but is associated with significant morbidity, high cost, and prolonged recovery. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) provides a minimally invasive alternative; however, the anastomosis often closes after removal of the lumen-apposing metal stent (LAMS), limiting its role to palliation. We evaluated feasibility of the double LAMS septotomy technique to achieve durable gastroenterostomy without reliance on indwelling stents.<\/jats:p>\n                  <jats:p>This was a multicenter pilot-feasibility study in which consecutive adults with GOO underwent EUS-GE with double LAMS septotomy between 2024 and 2025. Step one involved placement of two adjacent LAMS to create parallel gastroenteric fistulas. Step two, performed 3 months later, included stent removal with or without septotomy to consolidate the anastomosis. Technical success, clinical success, adverse events (AEs), and sustained patency of the anastomosis after LAMS removal were assessed prospectively.<\/jats:p>\n                  <jats:p>Six patients (Mean age 70.3 years, 50% benign GOO) underwent the procedure. Technical and clinical success rates were 100%. Four patients completed both steps, with sustained anastomotic patency confirmed endoscopically or radiographically. Among these, spontaneous septum necrosis occurred in two patients (50%) and two patients (50%) required septotomy. Nutritional status improved (mean albumin +0.75 g\/dL). There were no major AEs. The patients had no recurrence of symptoms after a mean follow up 26.2 weeks and 17.8 weeks after step one and step two, respectively.<\/jats:p>\n                  <jats:p>The double LAMS septotomy technique is technically feasible, safe, and achieves durable gastrojejunostomy. This strategy may broaden the therapeutic role of EUS-GE in benign disease.<\/jats:p>","DOI":"10.1055\/a-2801-5033","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:03:03Z","timestamp":1769731383000},"source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Durable endoscopic gastrojejunal anastomosis using the double-lumen apposing metal stent septotomy technique: Feasibility study"],"prefix":"10.1055","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1279-2960","authenticated-orcid":false,"given":"Kambiz","family":"Kadkhodayan","sequence":"additional","affiliation":[{"name":"Center For Interventional Endoscopy, AdventHealth, Orlando, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad Khaled","family":"Almujarkesh","sequence":"additional","affiliation":[{"name":"Gastroenterology, AdventHealth Orlando, Orlando, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saurabh","family":"Chandan","sequence":"additional","affiliation":[{"name":"Center For Interventional Endoscopy, AdventHealth, Orlando, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Abassi","sequence":"additional","affiliation":[{"name":"Center For Interventional Endoscopy, AdventHealth, Orlando, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Cosgrove","sequence":"additional","affiliation":[{"name":"Center For Interventional Endoscopy, AdventHealth, Orlando, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maham","family":"Hayat","sequence":"additional","affiliation":[{"name":"Center For Interventional Endoscopy, AdventHealth, Orlando, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa A","family":"Arain","sequence":"additional","affiliation":[{"name":"Center For Interventional Endoscopy, AdventHealth, Orlando, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepanshu","family":"Jain","sequence":"additional","affiliation":[{"name":"Center For Interventional Endoscopy, AdventHealth, Orlando, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sagar","family":"Pathak","sequence":"additional","affiliation":[{"name":"Center For Interventional Endoscopy, AdventHealth, Orlando, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando","family":"Rosales","sequence":"additional","affiliation":[{"name":"Center For Interventional Endoscopy, AdventHealth, Orlando, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Yang","sequence":"additional","affiliation":[{"name":"Center For Interventional Endoscopy, AdventHealth, Orlando, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Khalid","family":"Hasan","sequence":"additional","affiliation":[{"name":"Center For Interventional Endoscopy, AdventHealth, Orlando, Florida, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shayan","family":"Irani","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.gie.2020.06.057","article-title":"Endoscopic gastrointestinal anastomosis: a review of established techniques","volume":"93","author":"MK Marrache","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/j.dld.2025.03.012","article-title":"What is the benefit of endoscopic ultrasound-guided gastrojejunal anastomosis for patients with benign gastric outlet obstruction? A systematic review with meta-analysis","volume":"57","author":"GEM Rizzo","year":"2025","journal-title":"Digest Liver Dis"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"E1474","DOI":"10.1055\/a-0996-8178","article-title":"al. Efficacy and safety of EUS-guided gastroenterostomy for benign and malignant gastric outlet obstruction: a systematic review and meta-analysis","volume":"7","author":"TR McCarty","year":"2019","journal-title":"Endosc Int Open"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1097\/MCG.0000000000002130","article-title":"EUS-guided gastroenterostomy for benign gastric outlet obstruction: A systematic review and meta-analysis","volume":"60","author":"A Canakis","year":"2026","journal-title":"J Clin Gastroenterol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"E361","DOI":"10.1055\/a-1783-8949","article-title":"al. Endoscopic ultrasound-guided gastroenterostomy versus surgical gastrojejunostomy in treatment of malignant gastric outlet obstruction: Systematic review and meta-analysis","volume":"10","author":"S Bomman","year":"2022","journal-title":"Endosc Int Open"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"E660","DOI":"10.1055\/a-2098-2570","article-title":"EUS-guided gastroenterostomy vs. surgical gastrojejunostomy and enteral stenting for malignant gastric outlet obstruction: a meta-analysis","volume":"11","author":"C Miller","year":"2023","journal-title":"Endosc Int Open"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"3992","DOI":"10.1038\/s41598-021-83618-x","article-title":"Feasibility and patency of echoendoscopic anastomoses with lumen apposing metal stents depending on the gastrointestinal segment involved","volume":"11","author":"M Bet\u00e9s","year":"2021","journal-title":"Sci Rep"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/j.gie.2019.11.017","article-title":"EUS-guided gastroenteric anastomosis as a bridge to definitive treatment in benign gastric outlet obstruction","volume":"91","author":"TW James","year":"2020","journal-title":"Gastrointest Endosc"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.14309\/ctg.0000000000000648","article-title":"Long-term outcomes of EUS-guided gastroenterostomy: A large, single-center experience","volume":"16","author":"JA Trieu","year":"2025","journal-title":"Clin Transl Gastroenterol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1016\/j.vgie.2025.06.002","article-title":"EUS-assisted gastric outlet remodeling in a patient with refractory gastrojejunal anastamotic stricture","volume":"10","author":"K Kadkhodayan","year":"2025","journal-title":"VideoGIE"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.scrs.2022.100879","article-title":"The science of anastomotic healing","volume":"33","author":"RB Morgan","year":"2022","journal-title":"Semin Colon Rectal Surg"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1002\/deo2.70084","article-title":"Pilot study of a novel lumen-apposing metal stent for endoscopic ultrasound-guided procedures in porcine models","volume":"5","author":"B Mangiavillano","year":"2025","journal-title":"DEN Open"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"2247","DOI":"10.1007\/s00384-021-04014-5","article-title":"Intestinal anastomotic healing models during experimental colitis","volume":"36","author":"JRE Miltschitzky","year":"2021","journal-title":"Int J Colorectal Dis"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.1016\/j.surg.2022.11.030","article-title":"al. Comparative early histologic healing quality of magnetic versus stapled small bowel anastomosis","volume":"173","author":"AS Ore","year":"2023","journal-title":"Surgery"},{"key":"ref15","doi-asserted-by":"crossref","DOI":"10.1002\/jcla.23493","article-title":"al. The immunologic changes during different phases of intestinal anastomotic healing","volume":"34","author":"F Zhang","year":"2020","journal-title":"J Clin Lab Anal"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2160","DOI":"10.1007\/s11605-020-04680-w","article-title":"The biology of anastomotic healing-the unknown overwhelms the known","volume":"24","author":"A Lam","year":"2020","journal-title":"J Gastrointest Surg"}],"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2801-5033.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T07:17:01Z","timestamp":1778224621000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2801-5033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,29]]},"references-count":16,"journal-issue":{"issue":"CP","published-online":{"date-parts":[[2026,1,13]]},"published-print":{"date-parts":[[2026]]}},"alternative-id":["a28015033"],"URL":"https:\/\/doi.org\/10.1055\/a-2801-5033","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1,29]]},"published":{"date-parts":[[2026,1,29]]}}}