title: Self-expandable stents in malignant colonic obstruction: insertion assisted with a sphincterotome in technically difficult cases.
abstract: BACKGROUND
  Stent placement is effective in relieving malignant colonic obstruction. Nevertheless, the technique may offer difficulties in sharply angulated lesions.
  
  
  METHODS
  Guidewire insertion assisted with a sphincterotome was performed in 4 patients with intestinal obstruction caused by malignant colonic strictures. The manipulation of the sphincterotome by turning and bending its tip allows the cannulation of the lesion with the guidewire and, as a consequence, the stent insertion.
  
  
  METHODS
  The procedure was successfully performed in 4 technically difficult cases in which it had been impossible to pass the guidewire with the standard catheter.
  
  
  CONCLUSIONS
  In technically difficult cases, with the use of a sphincterotome, insertion of the guidewire appears to be easier. This new method may improve technical success rates in stent placement.
authors.affiliation: Department of Gastroenterology, Complejo Hospitalario Juan Canalejo, La Coruna, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Vázquez-Iglesias
authors.forename: Benito
authors.initials: B
authors.lastname: Gonzalez-Conde
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Vázquez-Millán
authors.forename: Emilio
authors.initials: E
authors.lastname: Estévez-Prieto
authors.forename: Pedro
authors.initials: P
authors.lastname: Alonso-Aguirre
mesh_terms: D003110:Colonic Neoplasms / Q000150:complications* / Q000473:pathology; D003113:Colonoscopy / Q000379:methods*; D004867:Equipment Design; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000473:pathology* / Q000628:therapy*; D008297:Male; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D015607:Stents; D016896:Treatment Outcome