Feasibility of therapeutic endoscopic ultrasound in the bridge-to-surgery scenario: The example of pancreatic adenocarcinoma

Figure 2 Endoscopic ultrasound-guided gastrojejunostomy. A and B: The small bowel has been distended with saline infusion through a nasojejunal tube. The dilated jejunal loop has been identified through the gastric wall by endosonography and has been accessed through a 20 mm enhanced lumen apposing metal stent (arrow: tip of the catheter; arrowhead: distal flange); under fluoroscopic (A) and endosonographic (B) guidance, demonstrating the opening of the distal flange (arrowhead) inside the small bowel (SB); C: The proximal flange of the electrocautery-enhanced lumen apposing metal stent has been released and dilated, and the SB can be visualized through the lumen apposing metal stent; D: Contrast injected through the nasojejunal tube can be aspirated through the lumen apposing metal stent inside the stomach.