Takano Yuichi, Tamai Naoki, Noda Jun, Yamawaki Masataka, Azami Tetsushi, Niiya Fumitaka, Nishimoto Fumiya, Maruoka Naotaka, Yamagami Tatsuya, Nagahama Masatsugu
Division of Gastroenterology, Department of Internal Medicine Showa University Fujigaoka Hospital Yokohama Kanagawa Japan.
Clin Case Rep. 2025 Jul 17;13(7):e70649. doi: 10.1002/ccr3.70649. eCollection 2025 Jul.
Endoscopic duodenal stent placement, a widely used procedure for managing malignant gastric outlet obstruction, has a high technical and clinical success rate. However, precise confirmation of stricture site during the procedure is sometimes challenging. This case report introduces a novel balloon anchoring method to address this challenge. An 87-year-old female diagnosed with gastric outlet obstruction due to pancreatic cancer underwent endoscopic duodenal stent placement. However, the stricture site was unclear on fluoroscopic imaging. A balloon catheter was inserted beyond the stricture, inflated, and retracted toward the oral side. The balloon was anchored on the anal side of the stricture, facilitating precise stricture site confirmation. Subsequently, an uncovered duodenal metal stent was successfully placed. The procedure was completed without adverse events, and the patient resumed eating the following day. By using the balloon anchoring method, duodenal stricture can be easily and accurately evaluated. After confirming the stricture, a duodenal stent can be placed at the optimal position. We believe this technique will contribute to the safety and reliability of the procedure.
内镜下十二指肠支架置入术是治疗恶性胃出口梗阻的一种广泛应用的方法，技术成功率和临床成功率都很高。然而，在手术过程中精确确认狭窄部位有时具有挑战性。本病例报告介绍了一种新颖的球囊锚定方法来应对这一挑战。一名87岁女性因胰腺癌被诊断为胃出口梗阻，接受了内镜下十二指肠支架置入术。然而，在透视成像中狭窄部位不明确。将球囊导管插入狭窄部位远端，充气后向口腔侧回缩。球囊被锚定在狭窄部位的肛门侧，便于精确确认狭窄部位。随后，成功置入了一枚未覆盖的十二指肠金属支架。手术过程顺利，无不良事件发生，患者次日恢复进食。通过使用球囊锚定方法，可以轻松、准确地评估十二指肠狭窄。确认狭窄后，可将十二指肠支架放置在最佳位置。我们相信这项技术将有助于提高手术的安全性和可靠性。
