title: Endoscopic Biliary Drainage Using Guidewire Cannulation in a Case with Severe Duodenal Stenosis Caused by Duodenal Undifferentiated Carcinoma.
abstract: We present a case of duodenal carcinoma, 12 cm in size, with severe stenosis at the second portion of the duodenum. When the patient developed obstructive jaundice, it was impossible to perform endoscopic biliary drainage by standard cannulation due to the stenosis, but was succeeded by wire-guided cannulation using papillotome. Histology of the tumor showed undifferentiated carcinoma without differentiation to any specific cell type. Systemic chemotherapy was started with 5-FU, leucovorin and oxaliplatin. Biliary stent worked well until the patient succumbed three months after. Herein we demonstrate the new advantage of wire-guided cannulation in case of duodenal stenosis.
authors.affiliation: Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsubayashi
authors.forename: Naomi
authors.initials: N
authors.lastname: Kakushima
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Onozawa
authors.forename: Keiko
authors.initials: K
authors.lastname: Sasaki
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Uesaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ono