Transhepatic approach for retrograde D2 duodenal stent placement, new technique and case series.

Transhepatic duodenal stent placement may be a solution when endoscopy fails or when duodenal and biliary stents are needed simultaneously. This approach is usually not considered an option when the stent must be deployed entirely across the ampulla of Vater. We present a case series of 10 patients having undergone a novel transhepatic technique to place a duodenal stent across the ampulla of Vater, by establishing a wire scaffold from the liver toward the jejunum, then curving back on itself retrogradely through the duodenal tumor and out the mouth. Technical success was 90% with no associated mortality.