Gastrointest Interv.  2018 Apr;7(1):36-39. 10.18528/gii160029.

Percutaneous placement of H-configured triple biliary and enteral stents through a single access: A solution for complex bilio-enteric obstruction

• Park S
• Park AW

• KMID: 2439204
• DOI: http://doi.org/10.18528/gii160029

Abstract

A 75-year-old male with recurrent pancreatic adenocarcinoma after a previous Whipple's procedure presented with jaundice. The local advancement of the tumor caused obstructions of the common bile duct, intrahepatic bile duct hilum, and small bowel. Endoscopic stent insertion was precluded by the Roux-en-Y reconstruction. A successful transhepatic percutaneous single-access stenting of the whole biliary tree and intestine was achieved by H-configured triple stenting by combining T-configured dual stent placement in the biliary system with a duodenal stent insertion across the bottom of the anastomosis after looping a wire in the afferent limb. The "˜H-configured' stents remained patent for 10 months without major or minor complications. This technique adds a new minimal-invasive and effective palliative option for patients with obstruction of a bilio-enteric anastomosis inaccessible to endoscopy.

Keyword

Cholestasis; Gastric outlet obstruction; Stents

MeSH Terms

Adenocarcinoma
Aged
Bile Ducts, Intrahepatic
Biliary Tract
Cholestasis
Common Bile Duct
Endoscopy
Extremities
Gastric Outlet Obstruction
Humans
Intestines
Jaundice
Male
Stents*