Progress of Digestive Endoscopy
Online ISSN : 2187-4999
Print ISSN : 1348-9844
ISSN-L : 1348-9844
症例
Expandable Metallic Stent(EMS)挿入時にインナーシャフトがウエッジし抜去が困難となった胆管癌の1例
森野 文敏大野 隆川添 一哉蓮見 桂三北村 匡中野 史郎
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2003 年 62 巻 2 号 p. 146-147

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We report a case that during EMS stenting, an innershaft was impossible to remove because its edge was wedged in small intrahepatic bile duct, and we escaped from that situation by separating a shaft from delivery system and cutting the innershaft by using a loop-cutter under endoscopic control. This method was useful for a case of 76-year-old women who had a bile duct carcinoma. We carried out placement of a WallstentTM, but innershaft could not be removed. So we cut the innershaft by using a loop-cutter. After this treatment, general condition got better and jaundice was improved gradually. The remaining shaft spontaneously was dislocated in the duodenum after 60 days. We found it on an abdominal plain X-ray film. We got rid of that shaft, we found duodenal ulcer in the anal side of its edge. She survived almost one and a half year, and died of peritonitis. This case suggested that this method would be effective way when an innershaft is impossible to be removed in the procedure of under EMS stenting.
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© 2003 一般社団法人 日本消化器内視鏡学会 関東支部
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