title: Endoscopic fenestration of duodenal stents using argon plasma to facilitate ERCP.
abstract: BACKGROUND
  The presence of a duodenal stent may hinder attempts at ERCP for treatment of malignant biliary obstruction.
  
  
  OBJECTIVE
  We describe 2 patients in whom endoscopic fenestration of indwelling duodenal stents with an argon plasma coagulator facilitated successful ERCP.
  
  
  METHODS
  Single-center retrospective case series.
  
  
  METHODS
  Tertiary-referral center.
  
  
  METHODS
  Both patients had unresectable biliary malignancy with both duodenal and biliary obstruction.
  
  
  RESULTS
  Windows were cut into indwelling duodenal stents with argon plasma, which exposed the underlying papilla and allowed successful ERCP and stent placement.
  
  
  CONCLUSIONS
  Retrospective study and the small sample size.
  
  
  CONCLUSIONS
  Fenestration of duodenal stents using argon plasma is a simple technique that can facilitate ERCP.
authors.affiliation: Miles and Shirley Fiterman Center for Digestive Diseases, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55906, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Topazian
authors.forename: Todd H
authors.initials: TH
authors.lastname: Baron
mesh_terms: D001128:Argon; D001661:Biliary Tract Neoplasms / Q000150:complications / Q000175:diagnosis; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000150:complications / Q000175:diagnosis; D020878:Device Removal; D004380:Duodenal Obstruction / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology / Q000601:surgery*; D017075:Laser Coagulation / Q000379:methods*; D018570:Risk Assessment; D012494:Sampling Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D001128:Argon