Successful re-intervention through stent mesh after novel antireflux covered metal biliary stent placement.

Abstract

A novel antireflux covered metal stent (Kawasumi Duckbill Biliary Stent; Kawasumi Laboratories, Inc., Tokyo, Japan) has recently become available for malignant biliary obstruction in Japan. This is a laser-cut covered self-expandable metal stent (SEMS) with a duckbill-shaped antireflux valve attached to the duodenal end ([Fig. 1]). The valve is closed except when bile is flowing out; it can therefore prevent reflux of duodenal contents into the bile duct. However, this design makes re-intervention via the duodenal end of the stent challenging. Here, we describe a successful re-intervention through the stent mesh after this novel SEMS was in place.