Removal of a Decade-Long Indwelling Lumen-Apposing Metal Stent for Post–Roux-en-Y Gastric Bypass Gastrojejunostomy Stricture
Jameel Alp, Stuart K. Amateau, Daniel B. LeslieA lumen-apposing metal stent (LAMS) was placed across a benign gastrojejunostomy stricture in a patient with prior Roux-en-Y gastric bypass. The patient was lost to follow-up, and the stent remained indwelling for over 10 years without migration, bleeding, or perforation. Endoscopy revealed loss of the silicone covering with diffuse tissue ingrowth, and removal of the exposed nitinol wires required serial fragmentation. A new LAMS was subsequently placed to maintain the luminal patency, with follow-up arranged. We report the longest LAMS therapeutic dwell time, highlighting its favorable long-term biocompatibility in this case. As an isolated observation, it is hypothesis-generating and suggests that prolonged indwelling tolerance may occasionally occur in rare circumstances.