Endoscopic Duodenal Stent Placement for Malignant Gastric Outlet Obstruction Using the Balloon Anchoring Method

Endoscopic duodenal stent placement, a widely used procedure for managing malignant gastric outlet obstruction, has a high technical and clinical success rate. However, precise confirmation of stricture site during the procedure is sometimes challenging. This case report introduces a novel balloon anchoring method to address this challenge. An 87-year-old female diagnosed with gastric outlet obstruction due to pancreatic cancer underwent endoscopic duodenal stent placement. However, the stricture site was unclear on fluoroscopic imaging. A balloon catheter was inserted beyond the stricture, inflated, and retracted toward the oral side. The balloon was anchored on the anal side of the stricture, facilitating precise stricture site confirmation. Subsequently, an uncovered duodenal metal stent was successfully placed. The procedure was completed without adverse events, and the patient resumed eating the following day. By using the balloon anchoring method, duodenal stricture can be easily and accurately evaluated. After confirming the stricture, a duodenal stent can be placed at the optimal position. We believe this technique will contribute to the safety and reliability of the procedure.