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KMID : 1048120180070010034
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International Journal of Gastrointestinal Intervention
2018 Volume.7 No. 1 p.34 ~ p.35
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Combined use of a two-channel endoscope and a flexible tip catheter for difficult biliary cannulation
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Kuwatani Masaki
Kubota Yoshimasa
Kawahata Shuhei
Kubo Kimitoshi
Kawakubo Kazumichi
Kawakami Hiroshi
Sakamoto Naoya
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Abstract
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A 69-year-old woman with jaundice was referred to our hospital. After a final diagnosis of pancreatic cancer with liver metastasis, we performed transpapillary biliary drainage with a covered self-expandable metal stent (SEMS). Three months later, we also placed an uncovered duodenal stent for duodenal stricture in a side-to-end fashion. Another month later, for biliary SEMS obstruction, we attempted a transpapillary approach. A duodenoscope was advanced and a guidewire was passed through the mesh of the duodenal stent into the bile duct with a flexible tip catheter, but the catheter was not. Thus, we exchanged the duodenoscope for a forward-viewing two-channel endoscope and used the left working channel with a flexible tip catheter. By adjusting the axis, we finally succeeded biliary cannulation and accomplished balloon cleaning for recanalization of the SEMS. This is the first case with successful biliary cannulation by combined use of a two-channel endoscope and a flexible tip catheter.
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KEYWORD
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Bile duct obstruction, Catheters, Endoscopes
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