Partial stent-in-stent placement of biliary metallic stents using a short double-balloon enteroscopy

World J Gastroenterol. 2012 Dec 7;18(45):6674-6. doi: 10.3748/wjg.v18.i45.6674.

Abstract

Endoscopic intervention is less invasive than percutaneous or surgical approaches and should be considered the primary drainage procedure in most cases with obstructive jaundice. Recently, therapeutic endoscopic retrograde cholangiopancreatography (ERCP) using double-balloon enteroscopy (DBE) has been shown to be feasible and effective, even in patients with surgically altered anatomies. On the other hand, endoscopic partial stent-in-stent (PSIS) placement of self-expandable metallic stents (SEMSs) for malignant hilar biliary obstruction in conventional ERCP has also been shown to be feasible, safe and effective. We performed PSIS placement of SEMSs for malignant hilar biliary obstruction due to liver metastasis using a short DBE in a patient with Roux-en-Y anastomosis and achieved technical and clinical success. This procedure can result in quick relief from obstructive jaundice in a single session and with short-term hospitalization, even in patients with surgically altered anatomies.

Keywords: Double-balloon enteroscopy; Malignant hilar biliary obstruction; Partial stent in stent; Roux-en-Y anastomosis; Self-expandable metallic stent.

Publication types

  • Case Reports

MeSH terms

  • Anastomosis, Roux-en-Y / methods
  • Biliary Tract / pathology*
  • Cholangiopancreatography, Endoscopic Retrograde / methods*
  • Double-Balloon Enteroscopy / methods*
  • Humans
  • Jaundice, Obstructive / surgery
  • Liver Neoplasms / surgery
  • Male
  • Metals
  • Middle Aged
  • Neoplasm Metastasis
  • Stents
  • Treatment Outcome

Substances

  • Metals