Self-expandable stents in malignant colonic obstruction: insertion assisted with a sphincterotome in technically difficult cases.

Background: Stent placement is effective in relieving malignant colonic obstruction. Nevertheless, the technique may offer difficulties in sharply angulated lesions.

Methods: Guidewire insertion assisted with a sphincterotome was performed in 4 patients with intestinal obstruction caused by malignant colonic strictures. The manipulation of the sphincterotome by turning and bending its tip allows the cannulation of the lesion with the guidewire and, as a consequence, the stent insertion.

Observations: The procedure was successfully performed in 4 technically difficult cases in which it had been impossible to pass the guidewire with the standard catheter.

Conclusions: In technically difficult cases, with the use of a sphincterotome, insertion of the guidewire appears to be easier. This new method may improve technical success rates in stent placement.