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Endoscopic fenestration of duodenal stents using argon plasma to facilitate ERCP

Mark Topazian¹, Todd H Baron

¹Miles and Shirley Fiterman Center for Digestive Diseases, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota 55906, USA.

Gastrointestinal Endoscopy

|December 30, 2008

Abstract

Background:

The presence of a duodenal stent may hinder attempts at ERCP for treatment of malignant biliary obstruction.

Objective:

We describe 2 patients in whom endoscopic fenestration of indwelling duodenal stents with an argon plasma coagulator facilitated successful ERCP.

Design:

Single-center retrospective case series.

Setting:

Tertiary-referral center.

Patients:

Both patients had unresectable biliary malignancy with both duodenal and biliary obstruction.

Intervention And Results:

Windows were cut into indwelling duodenal stents with argon plasma, which exposed the underlying papilla and allowed successful ERCP and stent placement.

Limitations:

Retrospective study and the small sample size.

Conclusions:

Fenestration of duodenal stents using argon plasma is a simple technique that can facilitate ERCP.

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