Management of Simultaneous Biliary and Duodenal Obstruction: the Endoscopic Perspective

Overview

Journal Gut Liver

Specialty Gastroenterology

Date 2010 Nov 25

PMID 21103295

Citations 11

Authors

Todd H Baron

Affiliations

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Abstract

Obstructive jaundice often develops in patients with unresectable malignancy in and around the head of the pancreas. Duodenal obstruction can also occur in these patients, and usually develops late in the disease course. Palliation of both malignant biliary and duodenal obstruction is traditionally performed with surgical diversion of the bile duct and stomach, respectively. With the advent of nonsurgical palliation of biliary obstruction using endoscopic transpapillary expandable metal stent placement, a similar approach can be used to palliate duodenal obstruction by placement of expandable metal gastroduodenal stents. Endoscopic palliation can be achieved in patients who require relief of both biliary obstruction and duodenal obstruction, although this can be technically difficult to achieve depending on the level of duodenal obstruction in relation to the major papilla. This article reviews the endoscopic approaches for combined palliative relief of malignant biliary and duodenal obstruction.

Citing Articles

Endoscopic Management of Concomitant Malignant Biliary and Gastric Outlet Obstruction.

Hossain I, Jardine H, Bonia K, Evans B Cureus. 2025; 16(12):e75635.

PMID: 39803149 PMC: 11725324. DOI: 10.7759/cureus.75635.

Endoscopic stenting for malignant biliary obstruction is technically successful in patients with preexisting duodenal stents.

Simoes P, Schattner M, Gerdes H, Shah P, Kurtz R, Mendelsohn R Endosc Int Open. 2022; 10(4):E429-E433.

PMID: 35433215 PMC: 9010099. DOI: 10.1055/a-1783-9310.

[Palliative endoscopy].

Arnstadt B, Allescher H Chirurg. 2021; 93(3):310-322.

PMID: 34137905 DOI: 10.1007/s00104-021-01426-5.

EUS-guided choledocoduodenostomy and gastroenterostomy to palliate simultaneous biliary and duodenal obstruction due to pancreatic cancer.

Lajin M Endosc Int Open. 2020; 8(11):E1681-E1682.

PMID: 33140024 PMC: 7581483. DOI: 10.1055/a-1236-3540.

Nutritional Support of Cancer Patients without Oral Feeding: How to Select the Most Effective Technique?.

Nunes G, Fonseca J, Barata A, Dinis-Ribeiro M, Pimentel-Nunes P GE Port J Gastroenterol. 2020; 27(3):172-184.

PMID: 32509923 PMC: 7250336. DOI: 10.1159/000502981.

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