A CASE OF SUCCESSFUL BILATERAL METAL STENTING USING DOUBLE PANCREATIC CANCER RECURRENCE AT THE ANASTOMOTIC SITE OF THE HEPATICOJEJUNOSTOMY AFTER PANCREATICODUODENECTOMY

Abstract

A 46-year-old woman who underwent pancreaticoduodenectomy with Child's reconstruction for pancreatic cancer developed jaundice because of recurrence at the anastomotic site of the hepaticojejunostomy. Bilateral metal stenting across the anastomotic site of the bile duct was achieved successfully using double balloon enteroscopy ; thus, the obstructive jaundice was resolved rapidly. The outcome in this case suggests that the placement of metal stents across the anastomotic site of the hepaticojejunostomy effectively dilated the malignant stricture due to the anastomotic recurrent tumor. Metal stent placement also may facilitate re-intervention if stent dysfunction would occur. If necessary, multiple stents for other proximal branches can be placed through mesh of the original distal metal stent.