VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2026
Advanced endoscopic rescue after failed endoscopic ultrasound-guided choledochoduodenostomy.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Michaelis Stefan, Rosien Ulrich, Arlt Alexander
Аннотация
BACKGROUND AND AIMS: EUS-guided choledochoduodenostomy (EUS-CDS) has become an established alternative to percutaneous or surgical approaches in cases of failed or predicted difficult ERCP.
METHODS: We report a case of complex endoscopic management of biliary obstruction in a 46-year-old woman with inoperable pancreatic adenocarcinoma. Because of tumor-related deformation of the papillary region, primary transpapillary drainage was not feasible.
RESULTS: EUS-CDS using a 6- × 8-mm electrocautery-enhanced lumen-apposing metal stent (LAMS) (Hot AXIOS stent; Boston Scientific, Marlborough, Mass, USA) was performed. Misdeployment of the distal flange led to bile leakage and stent dysfunction. Subsequent placement of a fully covered self-expandable metal stent (8 mm × 6 cm) (BONASTENT; MTW, Wesel, Germany) resulted in secondary stent dislocation into the paraduodenal space. The dislocated stent was successfully retrieved endoscopically through the original access using a 3-mm cholangioscope (Scivita, Boston Scientific). The duodenal defect was closed with 2 closure clips (MANTIS Clip, Boston Scientific). The patient recovered uneventfully and remained asymptomatic at 2-month follow-up.
CONCLUSIONS: This case illustrates the feasibility of endoscopic rescue in a challenging scenario after LAMS misdeployment using advanced ERCP and closure techniques.
METHODS: We report a case of complex endoscopic management of biliary obstruction in a 46-year-old woman with inoperable pancreatic adenocarcinoma. Because of tumor-related deformation of the papillary region, primary transpapillary drainage was not feasible.
RESULTS: EUS-CDS using a 6- × 8-mm electrocautery-enhanced lumen-apposing metal stent (LAMS) (Hot AXIOS stent; Boston Scientific, Marlborough, Mass, USA) was performed. Misdeployment of the distal flange led to bile leakage and stent dysfunction. Subsequent placement of a fully covered self-expandable metal stent (8 mm × 6 cm) (BONASTENT; MTW, Wesel, Germany) resulted in secondary stent dislocation into the paraduodenal space. The dislocated stent was successfully retrieved endoscopically through the original access using a 3-mm cholangioscope (Scivita, Boston Scientific). The duodenal defect was closed with 2 closure clips (MANTIS Clip, Boston Scientific). The patient recovered uneventfully and remained asymptomatic at 2-month follow-up.
CONCLUSIONS: This case illustrates the feasibility of endoscopic rescue in a challenging scenario after LAMS misdeployment using advanced ERCP and closure techniques.