Self-expandable stents in malignant colonic obstruction: insertion assisted with a sphincterotome in technically difficult cases.
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.
Vázquez-Iglesias
José Luis
JL
Department of Gastroenterology, Complejo Hospitalario Juan Canalejo, La Coruna, Spain.
Gonzalez-Conde
Benito
B
Vázquez-Millán
Maria Angeles
MA
Estévez-Prieto
Emilio
E
Alonso-Aguirre
Pedro
P
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