Abstract
A patient in his 80ʼs was referred to our hospital with a complaint of anorexia─of one month duration─and obstructive jaundice. Abdominal CT scan and GI tract survey revealed an advanced gallbladder carcinoma causing luminal strictures in the bile duct, the duodenum and the transverse colon with extensive peritoneal dissemination. Endoscopic stenting using covered self─expandable metallic stents (SEMS) was elected for treatment. First of all, on the fifth hospital day, a Flexxus Endoscopic Biliary Stent 10×80 mm was inserted into the bile duct. Secondly, on the 12th hospital day, a Wallflex Colonic Stent 22×90 mm was inserted into the transverse colon. A third procedure was performed on the 16th hospital day, when a Wallflex Duodenal Stent 22×90 mm was inserted into the duodenum. These procedures enabled the patient to food orally three days later. He maintained a good performance status (PS 0) for the following 4 months. The sequential triple endoscopic stentings were successfully preformed. This procedure is a useful method of palliative therapy for patients with various luminal strictures derived from malignant diseases in an advanced stage, in order to maintain quality of life and permit activities of daily living.
