title: A unique use of a double-pigtail plastic stent: correction of kinking of the common bile duct due to a metal stent.
abstract: A 72-year-old man with jaundice by ampullary adenocarci-noma was treated at our hospital. For biliary decompression, a transpapillary, fully covered, self-expandable metal stent (FCSEMS) was deployed. Four days later, the patient devel-oped acute cholangitis. Endoscopic carbon dioxide cholan-giography revealed kinking of the common bile duct above the proximal end of the FCSEMS. A 7-F double-pigtail plastic stent was therefore placed through the FCSEMS to correct the kink, straightening the common bile duct (CBD) and im-proving cholangitis. This is the first report of a unique use of a double-pigtail plastic stent to correct CBD kinking. The place-ment of a double-pigtail plastic stent can correct CBD kink-ing, without requiring replacement or addition of a FCSEMS, and can lead to cost savings.
authors.affiliation: Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kuwatani
authors.affiliation: Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawakami
authors.affiliation: Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Kawahata
authors.affiliation: Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Kawakubo
authors.affiliation: Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Kimitoshi
authors.initials: K
authors.lastname: Kubo
authors.affiliation: Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Sakamoto
mesh_terms: D000368:Aged; D003135:Common Bile Duct / Q000293:injuries*; D003251:Constriction, Pathologic / Q000601:surgery; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D000069322:Self Expandable Metallic Stents / Q000009:adverse effects; D015607:Stents; D014102:Torsion Abnormality / Q000601:surgery*
keywords: Adverse effects; Cholangiopancre-atography, endoscopic retrograde; Cholangitis; Common bile duct neoplasms; Stents