Successful biliary drainage using a metal stent through the gastric stoma

Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Yasuhiro Noma, Shigeru Horiguchi, Hiroyuki Okada, Kazuhide Yamamoto

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Abstract

We report a case of biliary drainage for malignant stricture using a metal stent with an ultrathin endoscope through the gastric stoma. A 78-year-old female was referred to our hospital for jaundice and fever. She had undergone percutaneous endoscopic gastrostomy (PEG) for esophageal obstruction after radiation therapy for cancer of the pharynx. Abdominal contrast-enhanced computed tomography showed a 3-cm enhanced mass in the middle bile duct and dilatation of the intrahepatic bile duct. We initially performed endoscopic retrograde cholangiopancreatography (ERCP) with a trans-oral approach. However, neither the side-viewing endoscope nor the ultrathin endoscope passed through the esophageal orifice. Thus, we eventually performed ERCP via the PEG stoma using an ultrathin endoscope. We performed biliary drainage with a 6F introducer self-expanding metal stent. The cytology findings obtained by brush cytology showed malignancy. Her laboratory results were restored to normal levels after drainage and no complication occurred.

Original languageEnglish
Pages (from-to)7594-7597
Number of pages4
JournalWorld journal of gastroenterology
Volume21
Issue number24
DOIs
Publication statusPublished - Jun 28 2015

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Keywords

  • Malignant biliary obstruction
  • Metal stent
  • Percutaneous endoscopic gastrostomy
  • Transgastrostomic endoscopy
  • Ultrathin endoscope

ASJC Scopus subject areas

  • Gastroenterology

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