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Advanced Pancreaticobiliary Endoscopy pp 121–133Cite as

Endoscopic Treatment of Simultaneous Malignant Biliary and Gastric Outlet Obstruction

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Abstract

Patients with advanced GI malignancies, most commonly pancreatic cancer, can develop combined biliary and gastric outlet obstruction. Formerly only treated by surgical gastric and biliary bypass, endoscopy with simultaneous endoscopic and biliary stenting is now the standard first-line approach. Several anatomic variants exist based on the location of the enteric obstruction relative to the Ampulla of Vater that has been shown to predict procedural success. In the event of failed biliary cannulation, alternative approaches including endoscopic ultrasound assisted biliary access and percutaneous approaches should be considered. This chapter covers the workup and therapeutic options to manage combined biliary and enteral obstruction.

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Authors and Affiliations

  1. The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, 1069, New York, NY, 10029, USA

    Brian P. Riff M.D. & Christopher J. DiMaio M.D.

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  1. Brian P. Riff M.D.
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  2. Christopher J. DiMaio M.D.
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Correspondence to Christopher J. DiMaio M.D. .

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  1. Salt Lake City, Utah, USA

    Douglas G. Adler

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Riff, B.P., DiMaio, C.J. (2016). Endoscopic Treatment of Simultaneous Malignant Biliary and Gastric Outlet Obstruction. In: Adler, D. (eds) Advanced Pancreaticobiliary Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-319-26854-5_8

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