Abstract
A 61-year-old woman was admitted to the hospital because of obstructive jaundice due to recurrence of gastric cancer to the pancreatic head region one year and 4 months after a gastrectomy. Expandable metallic stent (EMS) was inserted following percutaneous transhepatic biliary drainage, which resulted in maintaining normal bilirubin level for about a year. Ten months after biliary stenting, however, severe duodenal stenosis occurred because of a further extension of the disease. Then another EMS was placed between gastric outlet and proximal duodenum, which made her intake diet, and she was discharged from the hospital. Aggressive application of EMS remarkably improved her quality of life. The use of EMS for biliary strenosis has been established. On the other hand, successful uses of EMS for gastrointestinal organs other than the esophagus have been increasingly reported recently, though those indications have not been approved by the Japanese health insurance. We think that EMS therapy for gastrointestinal tract as well as biliary system is a promising modality for patients with malignant stenosis.
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