Cholangioscopy-assisted photodynamic therapy for cholangiocarcinoma

Abstract

identified. A 19-G needle was used to puncture the balloon. Contrast medium was injected through the needle under fluoroscopy to confirm the needle position within the small bowel. A second 0.035-inch hydrophilic wire was advanced through the needle and coiled within the lumen of the bowel. A needle-knife was used to dissect the fistulous tract. A 4 mm 4 cm balloon was used to dilate the fistulous tract. A 15 mm 10 mm lumen-apposing metal stent was then deployed under a combination of fluoroscopic, endoscopic, and echosonographic guidance (Fig. 1) (Video 1, available online at www.giejournal.org). The stent position was confirmed by direct endoscopic visualization and on fluoroscopy. A controlled radial expansion balloon was used to dilate the lumen of the stent to 13.5 mm. The patient’s obstructive symptoms improved immediately after the procedure. She was given a liquid diet on postoperative day 1.