Abstract
An 85-year-old man presenting with jaundice and a right upper abdominal mass was admitted. He had a history of distal gastrectomy with Billroth-Ⅱ reconstruction for gastric cancer. Computed tomography revealed a locally advanced tumor in the head of the pancreas, which invaded the third portion of the duodenum. Marked dilatation of the stump of the duodenum and intrahepatic hepatic bile duct were confirmed. Percutaneous transhepatic biliary and duodenal drainage were immediately performed via the papilla of Vater to treat acute cholangitis and prevent impending rupture of the duodenum. After the improvement of cholangitis, a duodenal metallic stent 22mm in width was placed in the stenotic site (length, 40mm) of the duodenum via the route used for percutaneous transhepatic biliary drainage. The malignant stenosis and jaundice improved, without complications. Oral intake was begun the day after stenting, and the stent remained patent during the patient's life.
