{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:41:33Z","timestamp":1762868493490,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,4,2]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>The development and refinement of endoscopic stenting techniques in recent years have made endoscopic treatment an important part of palliative care for irresectable malignant disease in the gastrointestinal tract. We present the case of a 82-year-old man with biliary obstruction and duodenal stenosis on the basis of disseminated pancreatic cancer. He was bothered by jaundice and reduced oral intake. This is typically alleviated using stents; however, the placement of a duodenal stent can limit the possibility of subsequent placement of a biliary stent. This therapeutic challenge was solved using a combination of lumen-apposing metal stents (LAMS) and self-expanding uncovered metal stents (SEMS). LAMS is a relatively novel type of stent intended for endoscopic ultrasonography-guided placement. First, we placed a SEMS in the duodenum, a LAMS was subsequently placed through the mesh of the duodenal SEMS, alleviating the biliary system. The patient was able to resume oral intake and his jaundice subsided.<\/jats:p>","DOI":"10.1136\/bcr-2020-238599","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T12:49:33Z","timestamp":1618490973000},"page":"e238599","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Lumen-apposing metal stent for treatment of malignant biliary obstruction, placed through an uncovered duodenal self-expanding metal stent"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8431-2623","authenticated-orcid":false,"given":"Rasmus","family":"Due-Petersson","sequence":"first","affiliation":[{"name":"Department of Surgery, Zealand University Hospital Koge, K\u00f8ge, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lasse Bremholm","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Zealand University Hospital Koge, K\u00f8ge, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"2025082803335063000_14.4.e238599.1","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1055\/a-0659-9864","article-title":"Endoscopic biliary stenting: indications, choice of stents, and results: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline - Updated October 2017","volume":"50","author":"Dumonceau","year":"2018","journal-title":"Endoscopy"},{"key":"2025082803335063000_14.4.e238599.2","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1080\/17434440.2019.1697229","article-title":"Colonic stents for malignant bowel obstruction: current status and future prospects","volume":"16","author":"Ormando","year":"2019","journal-title":"Expert Rev Med Devices"},{"key":"2025082803335063000_14.4.e238599.3","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i43.12468"},{"key":"2025082803335063000_14.4.e238599.4","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/S1040-8428(00)00108-6","article-title":"Endoscopic treatment of pancreatico-biliary malignancies","volume":"37","author":"Conio","year":"2001","journal-title":"Crit Rev Oncol Hematol"},{"key":"2025082803335063000_14.4.e238599.5","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1002\/jso.25483","article-title":"Endoscopic palliation of biliary obstruction","volume":"120","author":"Aadam","year":"2019","journal-title":"J Surg Oncol"},{"key":"2025082803335063000_14.4.e238599.6","doi-asserted-by":"crossref","first-page":"2866","DOI":"10.1007\/s00464-020-07484-w","article-title":"Effectiveness and safety of EUS-guided choledochoduodenostomy using lumen-apposing metal stents (LAMS): a systematic review and meta-analysis","volume":"34","author":"Krishnamoorthi","year":"2020","journal-title":"Surg Endosc"},{"key":"2025082803335063000_14.4.e238599.7","doi-asserted-by":"crossref","first-page":"7","DOI":"10.21037\/tgh.2019.01.05","article-title":"Palliative therapy in pancreatic cancer-interventional treatment with stents","volume":"4","author":"Waldthaler","year":"2019","journal-title":"Transl Gastroenterol Hepatol"},{"key":"2025082803335063000_14.4.e238599.8","doi-asserted-by":"crossref","first-page":"53","DOI":"10.4240\/wjgs.v11.i2.53","article-title":"Success and safety of endoscopic treatments for concomitant biliary and duodenal malignant stenosis: a review of the literature","volume":"11","author":"Mangiavillano","year":"2019","journal-title":"World J Gastrointest Surg"},{"key":"2025082803335063000_14.4.e238599.9","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1055\/s-0033-1359214","article-title":"Multicenter experience with performance of ERCP in patients with an indwelling duodenal stent","volume":"46","author":"Khashab","year":"2014","journal-title":"Endoscopy"},{"key":"2025082803335063000_14.4.e238599.10","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1007\/s00534-011-0409-2","article-title":"Endoscopic double-metallic stenting for malignant biliary and duodenal obstructions","volume":"18","author":"Moon","year":"2011","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"2025082803335063000_14.4.e238599.11","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1038\/s41395-018-0040-9","article-title":"Cautery-Tipped lumen Apposing metal stent placement through the mesh of an indwelling duodenal self-expanding metal stent","volume":"113","author":"Anderloni","year":"2018","journal-title":"Am J Gastroenterol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-238599","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:33:58Z","timestamp":1756377238000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-238599"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":11,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,15]]},"published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1136\/bcr-2020-238599"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-238599","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}