The thermodilator: an effective instrument in the palliative therapy concept of malignant bile duct stenosis
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Updated: Oct 21, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
U Weickert1, E Mühlen, J Janssen
1Medical Clinic A, Wuppertal Clinical Centre, Clinics of the University of Witten/Herdecke, Germany. uwe.weickert@cityweb.de
Background And Methods:
In the case of incurable malignant bile duct stenosis the aim of therapy is to secure the bile flow. Sometimes dilation of the stenosis is necessary to enable the introduction of a biliary duodenal stent or the replacement of a small-bore stent by a large-bore one. The previously most commonly used methods - bougienage and balloon dilation - can be unsuccessful with severe stenoses, which means that an extension of the endoscopic therapeutic instrumentarium is desirable. We examined the success rates and complications of a thermodilator which can be used to dilate bile duct stenoses.
Results And Conclusions:
In 21 out of 24 applications the therapeutic objective was achieved. In one case we observed an endoscopically controllable bile duct hemorrhage. The thermodilator is therefore a valuable addition to the endoscopic treatment possibilities of malignant bile duct stenosis.
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