Reversible endoscopic gastroduodenal bypass for the treatment of persistent duodenal leaks after failed surgical repair: a pilot feasibility study

Kambiz Kadkhodayan; Saurabh Chandan; Artur Viana; Maham Hayat; Natalie Cosgrove; Mustafa Arain; Deepanshu Jain; Abdullah Abbasi; Sagar Pathak; Dennis Yang; Muhammad K Hasan; Armando Rosales; Jay Redan; Shayan Irani

doi:10.1055/a-2544-8507

Back

Reversible endoscopic gastroduodenal bypass for the treatment of persistent duodenal leaks after failed surgical repair: a pilot feasibility study

Journal article

Open access

Peer reviewed

Reversible endoscopic gastroduodenal bypass for the treatment of persistent duodenal leaks after failed surgical repair: a pilot feasibility study

Kambiz Kadkhodayan, Saurabh Chandan, Artur Viana, Maham Hayat, Natalie Cosgrove, Mustafa Arain, Deepanshu Jain, Abdullah Abbasi, Sagar Pathak, Dennis Yang, …

Endoscopy, Vol.57(08), pp.892-898

08/2025

DOI: 10.1055/a-2544-8507

PMCID: PMC12307041

PMID: 39993435

Files and links (1)

url

https://doi.org/10.1055/a-2544-8507View

Published (Version of record) Open Access

Abstract

Background Post-surgical leaks following surgical repair of acute duodenal perforations carry high mortality. Reversible endoscopic gastroduodenal bypass (REGB) is a novel procedure that helps divert the acid-rich gastric stream away from the affected duodenum to promote tissue healing at the ulcer site. Methods REGB is a single-session, two-step procedure involving the creation of an endoscopic ultrasound-guided gastrojejunostomy using a lumen-apposing metal stent, followed by endosuturing and closure of the pylorus to achieve complete duodenal bypass. The outcomes of REGB and its reversal were prospectively evaluated in six patients with persistent post-surgical duodenal leaks. Results REGB was technically successful in all six patients (100%) with no procedure-related adverse events. All patients resumed oral intake within 3 days, experienced significant reductions in surgical drain output, and were discharged. One patient with metastatic breast cancer did not undergo REGB reversal. Among five patients who underwent REGB reversal after a mean of 52.6 days, technical success was achieved in all (100%), with complete healing of duodenal ulcers, absence of leaks on fluoroscopy, and resumption of a solid food diet. Conclusion REGB is a technically feasible, reversible, and minimally invasive alternative for managing post-surgical duodenal leaks. Further studies are needed to validate its safety and efficacy.

Surgery

Gastroenterology & Hepatology

Life Sciences & Biomedicine

Science & Technology

Details

Title: Subtitle: Reversible endoscopic gastroduodenal bypass for the treatment of persistent duodenal leaks after failed surgical repair: a pilot feasibility study
Creators: Kambiz Kadkhodayan - AdventHealth Orlando
Saurabh Chandan - AdventHealth Orlando
Artur Viana - AdventHealth Orlando
Maham Hayat - AdventHealth East Orlando
Natalie Cosgrove - AdventHealth Orlando
Mustafa Arain - AdventHealth Orlando
Deepanshu Jain - AdventHealth Orlando
Abdullah Abbasi - AdventHealth Orlando
Sagar Pathak - AdventHealth Orlando
Dennis Yang - AdventHealth Orlando
Muhammad K Hasan - AdventHealth Orlando
Armando Rosales - AdventHealth, Ctr Intervent Endoscopy, 601 E Rollins St, Orlando, FL 32803 USA
Jay Redan - AdventHealth East Orlando
Shayan Irani - Virginia Mason Medical Center
Resource Type: Journal article
Publication Details: Endoscopy, Vol.57(08), pp.892-898
DOI: 10.1055/a-2544-8507
PMID: 39993435
PMCID: PMC12307041
NLM abbreviation: Endoscopy
ISSN: 0013-726X
eISSN: 1438-8812
Publisher: Thieme Medical Publishers
Language: English
Electronic publication date: 05/14/2025
Date published: 08/2025
Academic Unit: Internal Medicine
Record Identifier: 9984843436102771

Metrics

9 Record Views