title: Endoscopic insertion of biliary stents in 18 patients with metallic duodenal stents who developed secondary malignant obstructive jaundice.
abstract: OBJECTIVE
  The aim of this work was to evaluate the feasibility of endoscopic insertion of biliary stents in patients with duodenal stents who develop secondary malignant obstructive jaundice.
  
  
  METHODS
  The study population included 133 patients with unresectable malignant duodenal obstruction. In 106 patients a biliary stent was inserted before or at the same time as the duodenal stent. Malignant biliary obstruction appeared secondarily in 18 patients; fifteen of these patients already had a biliary stent. We present our experience of biliary stent insertion in these 18 patients with metallic duodenal stents.
  
  
  RESULTS
  Biliary obstruction was successfully alleviated in 17 out of 18 patients (94%) without complication. Insertion of a new biliary stent failed in one patient because the mesh of the duodenal stent passed over the metallic biliary stent already in place. Mean duration of endoscopic insertion was 95 minutes (range: 60 - 180). All patients remained free of biliary complications to death (57 days, range: 30 - 120).
  
  
  CONCLUSIONS
  Our report shows that endoscopic insertion of a biliary stent is feasible in patients who have metallic duodenal stents. Technical difficulties exist especially if the mesh of the duodenal stent passes over the papilla.
authors.affiliation: Service d'Hépato-Gastroentérologie, Hôpital de l'Archet 2, CHU, Nice. geovbv@club-internet.fr
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Vanbiervliet
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Demarquay
authors.forename: Rémy
authors.initials: R
authors.lastname: Dumas
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Caroli-Bosc
authors.forename: Thierry
authors.initials: T
authors.lastname: Piche
authors.forename: Albert
authors.initials: A
authors.lastname: Tran
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004380:Duodenal Obstruction / Q000209:etiology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology / Q000628:therapy*; D008297:Male; D008670:Metals; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications*; D015607:Stents; D016896:Treatment Outcome
chemical_list: D008670:Metals