Combined endoscopic retrograde cholangiopancreatography- and endoscopic ultrasound-guided palliative biliary drainage in surgically altered anatomy.

ABSTRACT:

Background and aims

Long-term endoscopic management of malignant hilar biliary obstruction can be challenging, especially in cases with surgically altered anatomy.

Methods

A 37-year-old woman with newly diagnosed metastatic gastric adenocarcinoma status postneoadjuvant chemotherapy followed by a subtotal gastrectomy with Roux-en-Y reconstruction developed malignant hilar biliary obstruction. She underwent an ERCP via the use of a pediatric colonoscope, with sampling of the hilar stricture and stenting with a 7F × 12-cm plastic stent in the right hepatic duct. Pathology confirmed metastatic adenocarcinoma. ERCP with scheduled biliary stent exchange was recommended; however, the patient requested a long-term endoscopic solution to obviate routine stent exchange and avoid percu

SUBMITTER: Gala K 

PROVIDER: S-EPMC12827009 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature