Post written by Dennis Yang, MD, from the Division of Gastroenterology and Hepatology, University of Florida, Gainesville, Florida.
A 59-year-old man with newly diagnosed metastatic pancreatic cancer was referred for endoscopic treatment of concomitant gastric outlet obstruction and malignant biliary obstruction. Endoscopy revealed a severe type I stricture. ERCP was performed with successful placement of an uncovered metal biliary stent (10 mm x 60 mm). The short malignant stricture was noted to be immediately proximal to the ampulla. A lumen-apposing metal stent was used to treat the short duodenal stricture with successful restoration of luminal patency and without hindering the biliary stent.
The use of a LAMS in this case allowed successful treatment of a short malignant duodenal stricture without overlapping the biliary stent, potentially facilitating future biliary re-intervention if indicated.
Recent studies have alluded to the safety and efficacy of LAMSs for the management of short enteral strictures. Future studies are needed to further corroborate these preliminary findings and their potential role in the treatment of both benign and malignant GI strictures.
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