Metelli Flavio, Pezzoli Alessandro, Fabbri Carlo, Pizzo Elena, Arena Rosario, Cifalà Viviana, Simone Loredana, Solimando Riccardo, Merighi Alberto
Department of Gastroenterology and GI Endoscopy, University Hospital, Ferrara, Italy.
Department of Gastroenterology and GI Endoscopy, Forli-Cesena, Italy.
ACG Case Rep J. 2021 Nov 23;8(11):e00704. doi: 10.14309/crj.0000000000000704. eCollection 2021 Nov.
The palliation of simultaneous biliary and duodenal obstruction in patients with advanced pancreatic cancer is a clinically and technically challenging scenario. Endoscopic procedures are a valid alternative to surgical or percutaneous transhepatic biliary drainage. The availability of self-expanding metal stents (SEMSs) and lumen-apposing metal stents (LAMS) have expanded therapeutic options. We describe a case in which biliary and duodenal obstructions were treated successfully with the combined use of SEMS and LAMS devices. Endoscopic ultrasound-guided biliary drainage with the use of new LAMS and a duodenal SEMS can be a valid option in expert hands as a palliative and minimally invasive treatment for gastric outlet and biliary obstruction.
晚期胰腺癌患者同时出现胆管和十二指肠梗阻的姑息治疗在临床和技术上是一个具有挑战性的情况。内镜手术是手术或经皮经肝胆道引流的有效替代方法。自膨式金属支架（SEMS）和管腔贴附金属支架（LAMS）的应用扩大了治疗选择。我们描述了一例通过联合使用SEMS和LAMS设备成功治疗胆管和十二指肠梗阻的病例。在内镜超声引导下使用新型LAMS和十二指肠SEMS进行胆道引流，对于有经验的医生来说，可作为胃出口和胆管梗阻的一种有效的姑息性微创治疗选择。
