Published online Mar 16, 2019. doi: 10.4253/wjge.v11.i3.256
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
Endoscopically or fluoroscopically guided dilation is a safe and effective alternative to surgery for patients with benign strictures of the gastric outlet.
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.
Choledochoscope-guided assessment and endoscopic therapy is a viable approach in relieving duodenal obstruction, if the conventional combined fluoroscopic and endoscopic methods fail.
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.