Tsutsumi K, Kato H, Tomoda T, Matsumoto K, Sakakihara I, Yamamoto N, Noma Y, Sonoyama T, Okada H, Yamamoto K. Partial stent-in-stent placement of biliary metallic stents using a short double-balloon enteroscopy. World J Gastroenterol 2012; 18(45): 6674-6676 [PMID: 23236244 DOI: 10.3748/wjg.v18.i45.6674]
Corresponding Author of This Article
Koichiro Tsutsumi, MD, Department of Gastroenterology and Hepatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. tsutsumi@cc.okayama-u.ac.jp
Article-Type of This Article
Case Report
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Koichiro Tsutsumi, Hironari Kato, Takeshi Tomoda, Kazuyuki Matsumoto, Ichiro Sakakihara, Naoki Yamamoto, Yasuhiro Noma, Takayuki Sonoyama, Hiroyuki Okada, Kazuhide Yamamoto, Department of Gastroenterology and Hepatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama 700-8558, Japan
Author contributions: Tsutsumi K, Kato H, Tomoda T, Matsumoto K, Sakakihara I, Yamamoto N, Noma Y, and Sonoyama T designed the research; Okada H and Yamamoto K finally approved the paper; and Tsutsumi K wrote the article.
Correspondence to: Koichiro Tsutsumi, MD, Department of Gastroenterology and Hepatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. tsutsumi@cc.okayama-u.ac.jp
Telephone: +81-86-2357219 Fax: +81-86-2255991
Received: May 14, 2012 Revised: July 27, 2012 Accepted: August 3, 2012 Published online: December 7, 2012
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.
