Endoscopic choledochoduodenostomy by lumen-apposing metal stent in jaundice recurrence after transpapillary metal stent placement.

Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CD) with placement of an electrocautery-enhanced lumen-apposing metal stent (EC-LAMS) has been increasingly used as an alternative treatment option in patients with distal malignant biliary obstruction and failed endoscopic retrograde cholangiopancreatography (ERCP) [1][2][3]. 4 Final fluoroscopic view of biliary self-expandable metal stent, biliary lumen-apposing metal stent, and duodenal stent. B Video 1 b Endoscopic ultrasound-guided choledochoduodenostomy by electrocautery-enhanced lumen-apposing metal stent and duodenal stent placement for biliary and duodenal malignant obstruction despite indwelling biliary self-expandable metal stent. [Extracted from the article]