Rescue management of recurrent duodenal and biliary obstruction due to lumen-apposing metal stent distal migration and duodenal stent ingrowth

Endoscopic palliation of concomitant biliary and duodenal malignant obstruction can be challenging because of difficult access to the papilla. Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) via a choledochoduodenostomy created using a lumen-apposing metal stent (LAMS) is an innovative and relatively new technique for palliation of distal biliary malignancy in patients with an unreacheable papilla [1] [2]...