Abstract

Endoscopic palliation of unresectable pancreatic cancer with obstruction of both the duodenum and the common bile duct (CBD) is cumbersome, with successful biliary drainage achieved in only 30% of the cases. In most of them, percutaneous biliary drainage is necessary. We present a patient with an unresectable mass of the pancreatic head causing both CBD and duodenal obstruction who, after an EUS-FNA with rapid onsite cytopathologic evaluation, which revealed pancreatic adenocarcinoma, underwent same-session EUS-guided biliary drainage with use of a newly developed biflanged lumenapposing fully covered metal stent (LAFCMS) mounted on an electrocautery-enhanced delivery system (Hot-AX

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