title: Endoscopic double stenting for the treatment of malignant biliary and duodenal obstruction due to pancreatic cancer.
abstract: BACKGROUND
  The purpose of the present study was to retrospectively evaluate endoscopic double stenting by endoscopic retrograde cholangiopancreatography-guided biliary drainage (ERCP-BD) and by endoscopic ultrasonography-guided biliary drainage (EUS-BD) for the treatment of non-resectable malignant biliary and duodenal obstruction.
  
  
  METHODS
  Medical records of 11 patients that underwent endoscopic double stenting from January 2008 to September 2012 were analyzed retrospectively.
  
  
  RESULTS
  Technical success rate was 100%, clinical success rate was 100%, early complication rate was 0% and late complication rate was 27.3% (cholangitis: two, perforation: one). Mean survival time from double stenting was 76.5 ± 67.8 days, mean patent period of the duodenal stent was 73.5 ± 69.7 days, and mean patent period of the biliary stent was 62.6 ± 60.4 days. Three (27.3%) patients were discharged (mean duration of hospitalization, 21.3 days). All patients could take food orally, and mean Gastric Outlet Obstruction Scoring System score after double stenting was 2.2 ± 0.9 points. ERCP-BD and EUS-BD were done in three and eight patients, respectively. There was no statistically significant difference between ERCP-BD and EUS-BD in terms of success rate and complication rate.
  
  
  CONCLUSIONS
  Our study revealed that endoscopic double stenting appears to be feasible and useful for the treatment of non-resectable malignant biliary and duodenal obstruction. In terms of selection criteria of ERCP-BD patients and EUS-BD patients, further prospective studies are mandatory.
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. tonozuka1978@gmail.com
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tonozuka
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sofuni
authors.forename: Fumihide
authors.initials: F
authors.lastname: Itokawa
authors.forename: Fuminori
authors.initials: F
authors.lastname: Moriyasu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D004380:Duodenal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome