Treating bilio-duodenal obstruction: Combining new endoscopic technique with 6 Fr stent introducer

Figure 1 Endoscopic view of the forward-viewing endoscope showing duodenal stricture at the second portion of duodenum.

Figure 2 Selective biliary cannulation conducted with a thin forward-viewing endoscope. A: Endoscopic view showing endoscopic retrograde cholangiopancreatography (ERCP) catheter approaching to the papilla; B: X-ray picture showing common bile duct cannulation conducted with wire-guided technique without contrast injection.

Figure 3 Biliary self-expandable metallic stent (SEMS) placement via a thin forward-viewing endoscope. A: An extra slim delivery catheter is inserted properly into the bile duct; B: SEMS is successfully placed.

Figure 4 Endoscopic view showing biliary metallic stent placement via a thin forward-viewing endoscope. A: The delivery catheter is successfully introduced into the bile duct; B: SEMS is successfully placed.

Figure 5 X-ray picture indicating successful placement of biliary, duodenal and esophageal stents.