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. 2022 Mar 14;28(10):976–984. doi: 10.3748/wjg.v28.i10.976

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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/

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Pancreaticoduodenectomy following endoscopic ultrasound-guided double bypass. A: The endoscopic ultrasound-guided gastrojejunostomy site is easily identified and a stable gastrojejunal anastomosis is visible (underlined by blue curves) between the stomach and the small bowel (SB); B-C: The endoscopic ultrasound-guided gastrojejunostomy site is opened with diathermic coagulation, the lumen apposing metal stent is removed (B), and the anastomosis cut (C); D: The SB is prepared for gastroenteric anastomosis, while the gastric defect will be closed using staplers. A classic pylorus-preserving pancreaticoduodenectomy is achievable.