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Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2019; 11(2): 53-61
Published online Feb 27, 2019. doi: 10.4240/wjgs.v11.i2.53
Success and safety of endoscopic treatments for concomitant biliary and duodenal malignant stenosis: A review of the literature
Benedetto Mangiavillano, Mouen A Khashab, Ilaria Tarantino, Silvia Carrara, Rossella Semeraro, Francesco Auriemma, Mario Bianchetti, Leonardo Henry Eusebi, Yen-I Chen, Luca De Luca, Mario Traina, Alessandro Repici
Benedetto Mangiavillano, Francesco Auriemma, Mario Bianchetti, Gastrointestinal Endoscopy Unit; Humanitas - Mater Domini, Castellanza 21053, Italy
Benedetto Mangiavillano, Alessandro Repici, Humanitas Huniversity, Hunimed, Pieve Emanuele, Milano 20090, Italy
Mouen A Khashab, Yen-I Chen, Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Maryland, Baltimore 21218, United States
Ilaria Tarantino, Mario Traina, Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT), Palermo 90100, Italy
Silvia Carrara, Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center IRCCS, Via Manzoni 56, 20089 Rozzano, Milan, Italy
Rossella Semeraro, Digestive Endoscopy Unit, Istituto Clinico Humanitas Research Hospital, Rozzano 20089, Italy
Leonardo Henry Eusebi, Unit of Gastroenterology, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
Luca De Luca, Gastroenterology and Digestive Endoscopy Unit, Ospedali Riuniti Marche Nord, Pesaro 61122, Italy
Alessandro Repici, Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Rozzano 20089, Italy
Author contributions: Mangiavillano B, Auriemma F, Chen YI and De Luca D designed research and wrote, edited and finalized the text; Bianchetti M, Semeraro R and Carrara S performed literature search and analyzed the data; Eusebi LH corrected the English form; Repici A, Khashab MA and Traina M reviewed the paper for important intellectual content.
Conflict-of-interest statement: No conflict of interest to declare.
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/
Corresponding author: Benedetto Mangiavillano, MD, Chief Doctor, Gastrointestinal Endoscopy Unit, Humanitas - Mater Domini, Via Gerenzano n.2, Milano, MI 20149, Italy. b_mangiavillano@hotmail.com
Telephone: +39-331-476205381
Received: December 8, 2018
Peer-review started: December 10, 2018
First decision: December 24, 2018
Revised: December 30, 2018
Accepted: January 23, 2019
Article in press: January 23, 2019
Published online: February 27, 2019
Abstract

Synchronous biliary and duodenal malignant obstruction is a challenging endoscopic scenario in patients affected with ampullary, peri-ampullary, and pancreatic head neoplasia. Surgical bypass is no longer the gold-standard therapy for these patients, as simultaneous endoscopic biliary and duodenal stenting is currently a feasible and widely used technique, with a high technical success in expert hands. In recent years, endoscopic ultrasonography (EUS) has evolved from a diagnostic to a therapeutic procedure, and is now increasingly used to guide biliary drainage, especially in cases of failed endoscopic retrograde cholangiopancreatography (ERCP). The advent of lumen-apposing metal stents (LAMS) has expanded EUS therapeutic options, and changed the management of synchronous bilioduodenal stenosis. The most recent literature regarding endoscopic treatments for synchronous biliary and duodenal malignant stenosis has been reviewed to determine the best endoscopic approach, also considering the advent of an interventional EUS approach using LAMS.

Keywords: Malignant biliary strictures, Malignant duodenal stenosis, Bilio-duodenal stenosis, Biliary self-expandable metal stent, Duodenal self-expandable metal stent, Lumen-apposing metal stents, Gastro-jejunostomy

Core tip: Concomitant biliary and duodenal malignant obstruction is a challenging endoscopic scenario in patients affected by ampullary, peri-ampullary and pancreatic head neoplasia. Surgical by-pass is no longer the gold-standard therapy for these patients, as simultaneous endoscopic biliary and duodenal stenting is a nowadays a feasible and widely used technique, with a high technical success in expert hands. The most recent literature regarding endoscopic treatments for concomitant biliary and duodenal malignant stenosis has been reviewed, to determine the best endoscopic approach considering also the advent of interventional endoscopic ultrasonography approach using lumen apposing metal stents.