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New approaches to endoscopic ultrasound-guided gastroenterostomy (EUSGE) are under development, incorporating devices designed for transluminal therapy. Herein is the initial reported use of a novel, double-flanged, fully covered, self-expandable, metal stent with cautery, aimed at refining the EUS-GE procedure. A 43-year-old man was diagnosed with paraduodenal pancreatitis and walledoff necrosis (WON) due to biliary pancreatitis. He showed symptoms of gastric outlet obstruction (GOO), such as vomiting. Computed tomography (CT) images revealed a large cystic mass occupying the pancreatic head and a fully covered metal stent in the common bile duct, which was deployed previously for biliary pancreatitis (▶Fig. 1). Treatment was aimed at drainage of the infected WON and relief from the symptoms of GOO. EUS-guided drainage of the WON was achieved using a fully covered, double-flanged, metal stent as previously reported [1, 2]. After 15 days, the patient’s condition had stabilized sufficiently for EUS-GE to be performed (▶Video1). The patient was placed in the prone position for the procedure and given general E-Videos

Preliminary use of a double-flanged, fully covered, self-expandable, metal stent with cautery in endoscopic ultrasound-guided gastroenterostomy