Use of an ultrathin gastroscope to allow endoscopic insertion of enteral wallstents without fluoroscopic monitoring.
Self-expanding metallic stents are useful in relieving tumoral obstruction in the gastrointestinal tract. Endoscopic insertion is usually made through the working channel of a therapeutic endoscope. Fluoroscopy during insertion is thought to be mandatory in most cases. Endoscopists sometimes encounter problems in using or accessing fluoroscopy facilities. This study describes a method to insert, under certain circumstances, enteral Wallstents using only endoscopic control. An ultrathin gastroscope is used to pass severe tumoral strictures and place a guide wire beyond the stenosis. The ultrathin gastroscope is removed leaving the guide wire in place, which is then inserted in a retrograde fashion into a therapeutic colonoscope, allowing insertion of through-the-scope stents. Successful insertion was achieved in 5 malignant gastric outlet obstructions and in 6 rectosigmoid tumoral obstructions. In conclusion, in some cases using an ultrathin endoscope to place a guide wire beyond the stricture can be useful for endoscopic placement of Wallstents without fluoroscopy.
García-Cano
J
J
Gastroenterology Service, Hospital Virgen de la Luz, Cuenca, Spain. j.garcia-cano@terra.es
D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000601:surgery; D018281:Cholangiocarcinoma / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004379:Duodenal Neoplasms / Q000601:surgery; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000601:surgery*; D020699:Gastroscopes; D005773:Gastroscopy; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012811:Sigmoid Neoplasms / Q000601:surgery; D015607:Stents; D016896:Treatment Outcome