Lumen-apposing metal stents (LAMSs), although initially created for draining pancreatic fluid collections, are frequently used in an “off-label” fashion. They have recently gained popularity as a means to facilitate ERCP in patients with surgically altered GI anatomy. We have previously described using LAMSs to create a temporary gastroenterostomy to facilitate ERCP in a patient with duodenal switch anatomy. 1 The present case describes the use of a LAMS to enable ERCP in a patient with a history of vertical sleeve gastrectomy converted to a Roux-en-Y gastric bypass.
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