Combined Endoscopic Stent-In-Stent Placement by Lumen-Apposing Metal Stents Through Self-Expanding Metal Stents for Simultaneous Malignant Biliary and Duodenal Obstruction

ABSTRACT The palliation of simultaneous biliary and duodenal obstruction in patients with advanced pancreatic cancer is a clinically and technically challenging scenario. Endoscopic procedures are a valid alternative to surgical or percutaneous transhepatic biliary drainage. The availability of self...

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Bibliographic Details
Published inACG case reports journal Vol. 8; no. 11; p. e00704
Main Authors Metelli, Flavio, Pezzoli, Alessandro, Fabbri, Carlo, Pizzo, Elena, Arena, Rosario, Cifalà, Viviana, Simone, Loredana, Solimando, Riccardo, Merighi, Alberto
Format Journal Article
LanguageEnglish
Published Maryland, MD Wolters Kluwer 01.11.2021
Subjects
Case Report
Endoscopy
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Summary:ABSTRACT The palliation of simultaneous biliary and duodenal obstruction in patients with advanced pancreatic cancer is a clinically and technically challenging scenario. Endoscopic procedures are a valid alternative to surgical or percutaneous transhepatic biliary drainage. The availability of self-expanding metal stents (SEMSs) and lumen-apposing metal stents (LAMS) have expanded therapeutic options. We describe a case in which biliary and duodenal obstructions were treated successfully with the combined use of SEMS and LAMS devices. Endoscopic ultrasound-guided biliary drainage with the use of new LAMS and a duodenal SEMS can be a valid option in expert hands as a palliative and minimally invasive treatment for gastric outlet and biliary obstruction.
ISSN:2326-3253
2326-3253
DOI:10.14309/crj.0000000000000704