Endoscopic ultrasound guided gastroenterostomy for efferent jeunal loop obstruction in a patient with previous pancreaticoduodenectomy and ascites

A 68-year-old man, who underwent pylorus-preserving pancreato-duodenectomy(PPPD) for pancreatic adenocarcinoma, after 12 months presented with symptoms of gastric outlet obstruction(GOO). Computed tomography(CT) scan showed tumor recurrence at the efferent jejunal loop(EJL), determining stomach dilation, peritoneal carcinomatosis and ascites ([Fig. 1]). The case was discussed at our multidisciplinary meeting: due to advanced stage of disease and...