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. 2021 May 27;9(6):E895–E900. doi: 10.1055/a-1399-8442

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The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

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Fig. 1 a — Endoscopy showing high-grade malignant obstruction of the duodenum. b, c EUS showing distended fluid-filled proximal jejunal limb aligned near vertically c with deployment of distal flange of the LLAMS under endosonographic guidance. d Endoscopy showing successful LLAMS placement in distal stomach e followed by dilation of the LLAMS-GE using a CRE balloon. f Endoscopy showing afferent and efferent jejunal lumen visualized across the LLAMS.