Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Mar 16, 2019; 11(3): 256-261
Published online Mar 16, 2019. doi: 10.4253/wjge.v11.i3.256
Choledochoscope with stent placement for treatment of benign duodenal strictures: A case report
Ryan Sung-Eun Cho, John Magulick, Shelby Madden, James Steven Burdick
Ryan Sung-Eun Cho, John Magulick, Department of Gastroenterology and Hepatology, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX 78253, United States
Shelby Madden, Department of Internal Medicine, San Antonio Uniformed Services Health Education Consortium, Dallas, TX 78253, United States
James Steven Burdick, Depart of Gastroenterology and Hepatology, Baylor University Medical Center, San Antonio, TX 78253, United States
Author contributions: Cho RS, Magulick JM, Madden S and Burdick JS contributed equally to this work. Cho RS wrote the paper.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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: Ryan Sung-Eun Cho, BSc, MD, Assistant Professor, Department of Gastroenterology and Hepatology, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Drive, JBSA Ft Sam Houston, San Antonio, TX 78253, United States. ryan.s.cho.mil@mail.mil
Telephone: +1-210-9169737
Received: February 9, 2019
Peer-review started: February 10, 2019
First decision: February19, 2019
Revised: March 7, 2019
Accepted: March 11, 2019
Article in press: March 11, 2019
Published online: March 16, 2019
Abstract
BACKGROUND

Endoscopically or fluoroscopically guided dilation is a safe and effective alternative to surgery for patients with benign strictures of the gastric outlet.

CASE SUMMARY

We describe two cases where a novel approach with a Spyglass® choledochoscope in assessing the extent of benign duodenal strictures and aiding in placement of duodenal stents for treatment of the strictures. Choledochoscope-guided wire and stent placement was successful in all cases, leading to symptom resolution related to benign duodenal obstruction. No major adverse events were observed.

CONCLUSION

Choledochoscope-guided assessment and endoscopic therapy is a viable approach in relieving duodenal obstruction, if the conventional combined fluoroscopic and endoscopic methods fail.

Keywords: Choledochoscope, Duodenal stricture, Intraluminal stent, Case report

Core tip: The choledochoscope has the advantages of a smaller form factor, leading to easier passage of the scope through luminal narrowing or stricture with added benefits of direct visualization. Additional benefits include avoiding looping in the stomach with the passage of the choledochoscope through the therapeutic gastroscope. This study is the first to report this unique technique, with other potential applications in both benign and malignant strictures in the upper gastrointestinal tract if the conventional combined fluoroscopic and endoscopic methods fail.