Post written by Mohamed A. Abdallah, MD, from the Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA.
We describe a case of a 70-year-old female with unresectable, locally advanced Bismuth-Corlette classification type IV perihilar cholangiocarcinoma who presented with cholangitis from plastic stents. In this case, we placed four uncovered self-expanding metal stents in a stent-in-stent configuration, completing a “triple Y-shaped” configuration. The selection of stent-in-stent method over side-by-side stents in this patient was made to facilitate endoscopic reintervention, including intraductal radiofrequency ablation of tumor ingrowth.
This is important because it demonstrates that serial Y-shaped stent-in-stent technique using laser cut open cell metal stents can provide effective drainage of multiple segments and sectors in very complex malignant hilar tumors when needed.
Endoscopists reading this post can learn how to perform the Y-stent in stent technique using specific types of stents with a systematic approach.
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