LAMS use in malignant stricture of duodenal apex with synchronous malignant biliary obstruction: a potentially effective and simpler endoscopic approach.

We report the first case of lumen apposing metal stent (LAMS) use in malignant stricture of the duodenal apex to treat gastric outlet obstruction (GOO) and to facilitate endoscopic retrograde management of synchronous malignant biliary obstruction due to pancreatic head adenocarcinoma. This technique may be an effective alternative and a simpler approach than current methodology to this endoscopically challenging condition.