Matsumoto K, Kato H, Tsutsumi K, Akimoto Y, Uchida D, Tomoda T, Yamamoto N, Noma Y, Horiguchi S, Okada H, Yamamoto K. Successful biliary drainage using a metal stent through the gastric stoma. World J Gastroenterol 2015; 21(24): 7594-7597 [PMID: 26140009 DOI: 10.3748/wjg.v21.i24.7594]
Corresponding Author of This Article
Kazuyuki Matsumoto, MD, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. matsumotokazuyuki0227@yahoo.co.jp
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/
Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Hiroyuki Okada, Kazuhide Yamamoto, Hiroyuki Noma, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
Author contributions: Matsumoto K and Kato H organized the report and wrote the paper; Tsutsumi K, Akimoto Y, Uchida D, Tomoda T, Yamamoto N, Noma H, Horiguchi S participated in the clinical work; Okada H and Yamamoto K helped by supervising and approving the final manuscript.
Conflict-of-interest: All the authors declare that they have no conflicts of interest associated with this article.
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: Kazuyuki Matsumoto, MD, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. matsumotokazuyuki0227@yahoo.co.jp
Telephone: +81-86-2357219 Fax: +81-86-2255991
Received: December 7, 2014 Peer-review started: December 8, 2014 First decision: December 26, 2014 Revised: January 8, 2015 Accepted: March 18, 2015 Article in press: March 19, 2015 Published online: June 28, 2015
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 intra-hepatic 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.
Core tip: The method of transgastrostomic endoscopy using an ultrathin endoscope has been reported in terms of its safety and various advantages. A 6F delivery system uncovered-type self-expanding metal stent (SEMS) has been developed, and this SEMS is able to pass through an endoscopic working channel at least 2.0 mm in diameter. To our knowledge, this is the first reported evaluation of the performance of biliary drainage for malignant stricture using a 6F introducer SEMS with an ultrathin endoscope through the percutaneous endoscopic gastrostomy stoma.
