title: Anchor-wire technique for multiple plastic biliary stents to prevent stent dislocation.
abstract: In endoscopic placement of multiple plastic biliary stents (PBSs), we sometimes experience proximal dislocation of the first PBS at the time of subsequent PBS insertion. We describe the case of a 79-year-old male with obstructive jaundice caused by cholangiocarcinoma who needed to receive multiple PBS placements for management of cholangitis. Although proximal dislocation of the first PBS was observed, we prevented the dislocation via our technique of using guidewire inserted from the distal end of the first PBS to the side hole as the anchor-wire. We could complete this technique only by inserting guidewire through the side hole of the first PBS during the process of releasing the first PBS and pulling out the guidewire and the inner sheath. It did not matter whether the anchor-wire went towards the third portion of the duodenum or the duodenal bulb. Here we introduce this "anchor-wire technique", which is useful for the prevention of PBS proximal dislocation in placing multiple PBSs.
authors.affiliation: Department of Gastroenterology, Kanto Central Hospital, 6-25-1 Kamiyouga, Setagaya-ku, Tokyo 158-8531, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hamada
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Nakai
authors.forename: Saburo
authors.initials: S
authors.lastname: Matsubara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Akiko
authors.initials: A
authors.lastname: Narita
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Koike
authors.forename: Shigeo
authors.initials: S
authors.lastname: Matsukawa
authors.forename: Tateo
authors.initials: T
authors.lastname: Kawase
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D000368:Aged; D001659:Biliary Tract / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000150:complications; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000209:etiology / Q000473:pathology / Q000601:surgery; D004322:Drainage / Q000379:methods*; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology / Q000473:pathology / Q000601:surgery; D008297:Male; D019919:Prosthesis Implantation / Q000379:methods*; D015607:Stents; D016896:Treatment Outcome