Digestive Diseases and Sciences

, Volume 64, Issue 9, pp 2445–2448 | Cite as

The Great View Forward: The Use of a Colonoscope for Distal Duodenal Stent Placement

  • A. Minervini
  • A. LauroEmail author
  • N. Pagano
  • S. Vaccari
  • V. D’Andrea
  • I. R. Marino
  • M. Cervellera
  • V. Tonini



Stent placement in the distal duodenum can be difficult. We describe a case report of a 94-year-old man with metastatic pancreatic head cancer compressing the third and fourth portions of the duodenum, treated by endoscopic stent placement using a colonoscope.

Areas Covered

A literature review highlighted two possible procedures for stent placement in the distal duodenum, namely forward-viewing and side-viewing endoscopies. Gastroscopes, duodenoscopes, enteroscopes, and colonoscopes have all been suggested for the purpose. For distal lesions, especially when the duodenal wall is stiffened due to compression or infiltration by neoplastic lesions, a conventional upper endoscope can be too short to reach the narrowed site in “push mode,” necessitating the use of a longer endoscope.

Expert Commentary

A colonoscope can be safely and effectively used to accomplish distal duodenal stent placement.


Duodenal obstruction Pancreatic cancer Palliation Endoscopy Stents 


CT scan

Computed tomography scan


Self-expandable metallic stent



We wish to thank Ms. Caterina Sommariva for her support in drafting the drawings.

Compliance with Ethical Standards

Conflict of interest

None of the authors have any conflicts of interest pertaining to this work.


  1. 1.
    Topazian M, Ring E, Grendell J, et al. Palliation of obstructing gastric cancer with steel mesh, self-expanding prostheses. Gastrointest Endosc. 1992;38:58–60.CrossRefGoogle Scholar
  2. 2.
    Kumar V, Ghostal UC, Mohindra S, et al. Palliation of malignant gastroduodenal obstruction with self-expandable metal stent using side- and forward-viewing endoscope: feasibility and outcome. J Gastroenterol Hepatol. 2019;3:65–70.Google Scholar
  3. 3.
    Grunwald D, Cohen J, Bartley A, et al. The location of obstruction predicts stent occlusion in malignant gastric outlet obstruction. Ther Adv Gastroenterol. 2016;9:815–822.CrossRefGoogle Scholar
  4. 4.
    Jung K, Ahn J, Jung H, et al. Outcomes of endoscopically inserted self-expandable metal stents in malignancy according to the type of stent and the site of obstruction. Surg Endosc. 2015;30:4001–4010.CrossRefGoogle Scholar
  5. 5.
    Lee E, Bourke M, Williams S, et al. Severity of initial stent angulation predicts reintervention after successful palliative enteral stenting for malignant luminal obstruction. J Gastroenterol Hepatol. 2011;26:484–491.CrossRefGoogle Scholar
  6. 6.
    Park JM, Min BH, Lee SH, et al. Feasibility of self-expandable metal stent placement with side-viewing endoscope for malignant distal duodenal obstruction. Dig Dis Sci. 2015;60:524–530. Scholar
  7. 7.
    Chiu KW, Razack A, Maraveyas A. Self-expandable metal stent placement for malignant duodenal obstruction distal to the bulb. Eur J Gastroenterol Hepatol. 2015;27:1466–1472.CrossRefGoogle Scholar
  8. 8.
    Espinel J, Pinedo E. A simplified method for stent placement in the distal duodenum: enteroscopy overtube. World J Gastrointest Endosc. 2011;3:225–227.CrossRefGoogle Scholar
  9. 9.
    Jeurnink SM, Repici A, Luigiano C, et al. Use of a colonoscope for distal duodenal stent placement in patients with malignant obstruction. Surg Endosc. 2009;23:562–567.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • A. Minervini
    • 1
  • A. Lauro
    • 1
    Email author
  • N. Pagano
    • 1
  • S. Vaccari
    • 1
  • V. D’Andrea
    • 2
  • I. R. Marino
    • 3
  • M. Cervellera
    • 1
  • V. Tonini
    • 1
  1. 1.Department of Emergency Surgery and GastroenterologySt. Orsola University HospitalBolognaItaly
  2. 2.Department of Surgical Sciences, Umberto I HospitalLa Sapienza UniversityRomeItaly
  3. 3.Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaUSA

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