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. 2013 Aug 16;5(8):412-6.
doi: 10.4253/wjge.v5.i8.412.

Dilation of a severe bilioenteric or pancreatoenteric anastomotic stricture using a Soehendra Stent Retriever

Koichiro Tsutsumi  1 , Hironari Kato, Ichiro Sakakihara, Naoki Yamamoto, Yasuhiro Noma, Shigeru Horiguchi, Ryo Harada, Hiroyuki Okada, Kazuhide Yamamoto
Affiliations

Dilation of a severe bilioenteric or pancreatoenteric anastomotic stricture using a Soehendra Stent Retriever

Koichiro Tsutsumi et al. World J Gastrointest Endosc. .

Abstract

Bilioenteric or pancreatoenteric anastomotic strictures often occur after surgery for a pancreaticobiliary disorder. Therapeutic endoscopic retrograde cholangiopancreatography using balloon enteroscopy has been shown to be feasible and effective in patients with such strictures. However, when a benign anastomotic stricture is severe, a dilation catheter cannot pass through the stricture despite successful insertion of the guidewire. We report on the usefulness of the Soehendra Stent Retriever over a guidewire for dilating a severe bilioenteric or pancreatoenteric anastomotic stricture under short double-balloon enteroscopy, in two patients with surgically altered anatomies.

Keywords: Bilioenteric anastomotic stricture; Dilation; Double-balloon enteroscopy; Pancreatoenteric anastomotic stricture; Soehendra Stent Retriever.

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Figures

Figure 1
Figure 1
Endoscopic view and cholangiography by short double-balloon enteroscopy in a 66-year-old male. A: Bilioenteric anastomotic stricture looking like a pinhole (arrow); B: Dilated bilateral intrahepatic bile ducts were revealed.
Figure 2
Figure 2
Dilation of the severe bilioenteric anastomotic stricture using a 7-Fr Soehendra Stent Retriever. A: The Soehendra Stent Retriever (SSR) was introduced to the anastomosis over the guidewire, and turned clockwise carefully with pressure to advance through the stricture into the bile duct; B: Fluoroscopic view showing dilation for the stricture by the SSR; C: Endoscopic view showing the dilated anastomosis by the SSR; D: Fluoroscopic view showing subsequent balloon dilation to 8-mm dia; E: Conclusive endoscopic view after balloon dilation for this severe bilioenteric anastomotic stricture.
Figure 3
Figure 3
Endoscopic view and pancreatography by short double-balloon enteroscopy in a 78-year-old female. A: Pancreatoenteric anastomotic stricture looking like a pinhole with pancreatic juice flowing out slightly (arrow); B: Dilated pancreatic duct and pancreatic stone (arrowhead) were revealed.
Figure 4
Figure 4
Dilation of the severe pancreatoenteric anastomotic stricture using a 7-Fr Soehendra Stent Retriever. A: The Soehendra Stent Retriever (SSR) was introduced to the anastomosis over the guidewire, and turned clockwise carefully with pressure to advance through the stricture into the pancreatic duct; B: Fluoroscopic view showing dilation for the stricture by the SSR; C: Endoscopic view showing the dilated anastomosis by the SSR; D: Fluoroscopic view showing subsequent balloon dilation to 6-mm dia; E: Conclusive endoscopic view after balloon dilation for this severe pancreatoenteric anastomotic stricture.
See this image and copyright information in PMC

References

    1. Shimatani M, Matsushita M, Takaoka M, Koyabu M, Ikeura T, Kato K, Fukui T, Uchida K, Okazaki K. Effective “short” double-balloon enteroscope for diagnostic and therapeutic ERCP in patients with altered gastrointestinal anatomy: a large case series. Endoscopy. 2009;41:849–854. - PubMed
    1. Soehendra N, Maydeo A, Eckmann B, Brückner M, Nam VC, Grimm H. A new technique for replacing an obstructed biliary endoprosthesis. Endoscopy. 1990;22:271–272. - PubMed
    1. Chahal P, Baron TH, Topazian MD, Petersen BT, Levy MJ, Gostout CJ. Endoscopic retrograde cholangiopancreatography in post-Whipple patients. Endoscopy. 2006;38:1241–1245. - PubMed
    1. Brand B, Thonke F, Obytz S, Binmoeller KF, Rathod V, Seitz U, Bohnacker S, Jäckle S, Soehendra N. Stent retriever for dilation of pancreatic and bile duct strictures. brand@uke.uni-hamburg.de. Endoscopy. 1999;31:142–145. - PubMed
    1. Silverman W, Slivka A. New technique for bilateral metal mesh stent insertion to treat hilar cholangiocarcinoma. Gastrointest Endosc. 1996;43:61–63. - PubMed

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