Management of a necrosed bile duct by combination of a fully covered metal biliary stent and endoscopic ultrasound-guided gastrojejunostomy.

The patient is a 71-year-old man with a history of pancreatic adenocarcinoma and uncovered metal biliary stent placement 16 months ago who was admitted with cholangitis and bacteremia (E. coli and Klebsiella) secondary to an occluded biliary stent. To prevent further contamination of the biliary tree, a 10-mm × 60-mm fully covered metal biliary stent (Wallflex; Boston Scientific, Marlborough, Massachusetts, USA) was placed within the uncovered stent (Fig. [Extracted from the article]