Endoscopic ultrasound-guided emergency choledochoduodenostomy through a double duodenal stent

With the advancement of oncologic and endoscopic therapies, the survival of patients with pancreatic cancer is increasing, even in patients with advanced disease, meaning complications due to previous treatments are being seen more frequently. We describe the case of a 57-year-old woman with advanced pancreatic adenocarcinoma that had been diagnosed 2 years before admission who presented with jaundice requiring biliary stenting. She had developed gastric outlet obstruction 1 year after diagnosis and an initial duodenal uncovered self-expandable metal stent (USEMS) had been placed, which was then followed by placement of a second stent because of tumor ingrowth ([Fig. 1]).