Endosonography-guided biliary drainage with one-step placement of a newly developed fully covered metal stent followed by duodenal stenting for pancreatic head cancer.
An 83-year-old man was admitted to our department, presenting with jaundice, fever, and nausea. CT revealed a pancreatic head tumor with duodenal invasion. Endoscopic transpapillary biliary drainage was unsuccessful due to stenosis at the second portion of the duodenum and tumor invasion to the papilla of Vater. Using a convex linear array echoendoscope, a fully-covered metal stent was placed across the puncture tract to bridge the duodenum and the bile duct. After improvement of jaundice, a duodenal metal stent was placed across the stricture of the duodenum. No procedure-related complications occurred. Neither migration nor obstruction of the two stents was observed during the three months followup period. Combination of ESBD using a fully covered metal stent and duodenal stenting is a feasible technique and possibly a less invasive treatment option for malignant biliary and duodenal obstruction compared to surgery.
Ito
Kei
K
Department of Gastroenterology, Sendai Medical Center, 5-22-1, Tsurugaya, Miyagino-ku, Sendai, Miyagi 983-0824, Japan.
Fujita
Naotaka
N
Noda
Yutaka
Y
Kobayashi
Go
G
Obana
Takashi
T
Horaguchi
Jun
J
Koshita
Shinsuke
S
Kanno
Yoshihide
Y
Ogawa
Takahisa
T
Kato
Yuhei
Y
Yamashita
Yasunobu
Y