Abstract

Bilateral stenting for malignant hilar obstruction remains challenging. Advancing introducers alongside an expanded SEMS can be difficult or impossible. Recent advances permit small diameter (6-7F) introducers for 8-10mm SEMS. A 6F introducer (Zilver 635®, Cook Endoscopy) allows tandem advancement of two introducers through a standard working channel (4.2mm). We report our experience with simultaneous or sequential bilateral SEMS placement at a tertiary referral center.

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