Endoscopic double-metallic stenting for malignant biliary and duodenal obstructions
- Authors
- Moon, Jong Ho; Choi, Hyun Jong
- Issue Date
- Sep-2011
- Publisher
- Springer Verlag
- Keywords
- Duodenal metallic stent; Biliary metallic stent; Stent in stent placement; Malignant biliary obstruction; Malignant duodenal obstruction
- Citation
- Journal of Hepato-Biliary-Pancreatic Sciences, v.18, no.5, pp 658 - 663
- Pages
- 6
- Journal Title
- Journal of Hepato-Biliary-Pancreatic Sciences
- Volume
- 18
- Number
- 5
- Start Page
- 658
- End Page
- 663
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/16282
- DOI
- 10.1007/s00534-011-0409-2
- ISSN
- 1868-6974
1868-6982
- Abstract
- Background Endoscopic metallic stenting is a safe, effective treatment for malignant biliary obstructions, but can be technically difficult when combined malignant biliary and duodenal obstructions exist. Available duodenal metallic stents feature a tight mesh unsuitable for transpapillary biliary stenting. We evaluated the feasibility and usefulness of new endoscopic procedures for endoscopic double-stent placement in managing such obstructions. Methods The through-the-scope duodenal metallic stent has a central cross-wired, unfixed structure that allows insertion of the biliary stent through the mesh wall of a duodenal stent. Transpapillary endoscopic placement of a biliary stent was performed through the lumen of this duodenal stent. Endoscopic ultrasound (EUS)-guided biliary drainage was performed successfully through the duodenal bulb after puncturing with a 19G needle. Biliary metallic stenting through the choledochoduodenal tract and effective drainage were achieved. Conclusions Use of a combined endoscopic biliary and duodenal stent inserted through the mesh of the new duodenal metallic stent is feasible and effective in managing the aforementioned obstructions. EUS-guided biliary metal stenting is a therapeutic option for endoscopic management when a failed transpapillary approach through the lumen of the duodenal stent occurs. The continued development of endoscopic procedures and devices should resolve issues associated with complicated strictures.
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