Virk GS, Parsa NA, Tejada J, Mansoor MS, Hida S. Successful stent-in-stent dilatation of the common bile duct through a duodenal prosthesis, a novel technique for malignant obstruction: A case report and review of literature. World J Gastrointest Endosc 2018; 10(9): 219-224 [PMID: 30283605 DOI: 10.4253/wjge.v10.i9.219]
Corresponding Author of This Article
Gurjiwan Singh Virk, MD, MSc, Doctor, Department of Medicine, Albany Medical Center, 47 New Scotland Ave, Albany, NY 12407, United States. virkg@amc.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Sep 16, 2018; 10(9): 219-224 Published online Sep 16, 2018. doi: 10.4253/wjge.v10.i9.219
Successful stent-in-stent dilatation of the common bile duct through a duodenal prosthesis, a novel technique for malignant obstruction: A case report and review of literature
Gurjiwan Singh Virk, Nour A Parsa, Juan Tejada, Muhammad Sohail Mansoor, Sven Hida
Gurjiwan Singh Virk, Department of Medicine, Albany Medical Center, Albany, NY 12047, United States
Nour A Parsa, Juan Tejada, Muhammad Sohail Mansoor, Sven Hida, Department of Gastroenterology, Albany Medical Center, Albany, NY 12047, United States
Author contributions: Tejada J, Parsa NA and Virk GS designed the report; Virk GS, Mansoor MS and Parsa NA performed the literature review; Virk GS and Parsa NA wrote the manuscript; Hida S and Tejada J reviewed the manuscript.
Informed consent statement: The patient involved in this study gave informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All authors have no conflicts of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gurjiwan Singh Virk, MD, MSc, Doctor, Department of Medicine, Albany Medical Center, 47 New Scotland Ave, Albany, NY 12407, United States. virkg@amc.edu
Telephone: +1-248-3202562 Fax: +1-518-2626873
Received: March 22, 2018 Peer-review started: March 22, 2018 First decision: April 18, 2018 Revised: June 12, 2018 Accepted: June 25, 2018 Article in press: June 27, 2018 Published online: September 16, 2018
Abstract
For patients suffering from both biliary and duodenal obstruction, endoscopic retrograde cholangiopancreatography (ERCP) with stent placement is the treatment of choice. ERCP through an already existing duodenal prosthesis is an uncommon procedure and furthermore no studies have reported installing a covered metal stent onto an already existing bare metal stent in the common bile duct (CBD). We describe a rare case of a stent-in-stent dilatation of the CBD through an already existing self-expanding metal stent in the second part of duodenum for the patient presenting with jaundice in setting of biliary and duodenal obstruction from pancreatic adenocarcinoma. The biliary obstruction was relieved with a decrease in bilirubin levels post-stenting.
Core tip: Patients with gastric outlet obstruction from duodenal, ampullary or pancreatic malignancy frequently develop biliary obstruction. These patients usually undergo prophylactic biliary stent placement as the likelihood of developing biliary stricture or obstruction is very high. Here, we present a case of a patient who already had a duodenal and biliary stent which required placement of a covered metal stent into the existing common bile duct prosthesis to relieve his biliary obstructive symptoms.
