PDF herunterladen
Open Access
CC BY 4.0 · Endoscopy 2025; 57(S 01): E907-E908
DOI: 10.1055/a-2648-7338
E-Videos

An anatomically designed duodenal stent with physiological drainage: effective endoscopic rescue in persistent perforation

Authors

  • Shao-wei Li‡

    1   Department of Gastroenterology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
    2   Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Linhai, China
    3   Institute of Digestive Diseases, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China

  • Xin-yu Fu‡

    1   Department of Gastroenterology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
    4   Dalian Medical University, Dalian, China (Ringgold ID: RIN36674)

  • Jinbang Peng

    1   Department of Gastroenterology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China

  • Saiqin He

    1   Department of Gastroenterology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China

  • Binbin Gu

    1   Department of Gastroenterology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China

  • Xinli Mao

    1   Department of Gastroenterology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
    2   Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Linhai, China
    3   Institute of Digestive Diseases, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China

  • Li-ping Ye

    1   Department of Gastroenterology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
    2   Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Linhai, China
    3   Institute of Digestive Diseases, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China

Gefördert durch: “Pioneer” and “Leading Goose” R&D Program of Zhejiang 2025C02139
Gefördert durch: Program of Taizhou Science and Technology Grant 23ywa33
Gefördert durch: Scientific Research Foundation of Taizhou Enze Medical Center Grant 24EZCG02
Gefördert durch: Major Research Program of Taizhou Enze Medical Center Grant 19EZZDA2
Gefördert durch: Open Project Program of Key Laboratory of Minimally Invasive Techniques and Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province 21SZDSYS01
Gefördert durch: Doctoral Fund of Taizhou Enze Medical Center Grant 2018BSKYQDJJ14
Gefördert durch: Medical Science and Technology Project of Zhejiang Province 2024KY1788, 2022PY101
Weitere Informationen
Auch verfügbar auf
  Lizenzen und Reprints
Preview

A 70-year-old woman with a refractory duodenal ulcer developed a 1.5-cm perforation at the duodenal bulb following two failed attempts at endoscopic hemostasis ([Fig. 1]). Placement of an over-the-scope clip for closure was unsuccessful, and resulted in sepsis.

Zoom
Fig. 1 Endoscopic views showing: a the original duodenal perforation; b a failed closure attempt using over-the-scope clips.

A nitinol duodenal covered stent (22 mm in diameter, 10 cm in length) was deployed endoscopically ([Fig. 2], [Video 1]). This stent integrates three key innovations: (i) a tripartite anchoring system – an umbrella-shaped gastric component for antral apposition, a cylindrical pyloric segment for radial fixation, and a bulbous duodenal anchor for coaptation; (ii) a papilla-aligned fenestration within the membranous mid-section to preserve physiological pancreatobiliary drainage; and (iii) optimized radial force distribution across segmented zones to minimize migration. Follow-up at 15 days confirmed closure of the complete perforation, and the stent was safely retrieved.

Zoom
Fig. 2 Images of treatment with a duodenal stent showing: a the fistula prior to insertion of the stent; b stent deployment; c the anchoring mechanism; d stent retrieval after the perforation had healed; e the anatomical design of the stent; f the healed perforation site.
Herunterladen
An anatomically designed duodenal stent that can both obliterate the fistula and provide physiological drainage is used to close a perforation of a refractory duodenal ulcer in an elderly frail woman.Video 1

Duodenal perforations are challenging owing to anatomical fragility and the enzyme-rich secretions [1] [2]. Conventional stents risk migration and obstructing drainage, thereby exacerbating leaks [3]. An anatomically designed duodenal stent uniquely addresses these limitations: its anchoring system ensures stable positioning without tissue injury, while the fenestration aligns precisely with the papilla, allowing continuous biliary/pancreatic flow into the bowel lumen. This design prevents reflux-related complications and promotes fistula healing by isolating the defect from digestive enzymes. The case underscores the stent’s dual role as a mechanical sealant and physiological conduit, which may be particularly critical in elderly patients with impaired healing.

Endoscopy_UCTN_Code_TTT_1AO_2AZ

Endoscopy E-Videos https://eref.thieme.de/e-videos

E-Videos is an open access online section of the journal Endoscopy, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high-quality video and are published with a Creative Commons CC-BY license. Endoscopy E-Videos qualify for HINARI discounts and waivers and eligibility is automatically checked during the submission process. We grant 100% waivers to articles whose corresponding authors are based in Group A countries and 50% waivers to those who are based in Group B countries as classified by Research4Life (see: https://www.research4life.org/access/eligibility/).

This section has its own submission website at https://mc.manuscriptcentral.com/e-videos.



Publikationsverlauf

Artikel online veröffentlicht:
20. August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany