Gallbladder cancer is the most common cause of hilar biliary obstruction; however, it rarely causes combined biliary, duodenal, and colon triple obstruction. In this case, the quality of life for a patient with recurrent gallbladder cancer with combined duodenal, colonic, and biliary obstruction was improved by endoscopic and endosonographic palliation, despite its technical difficulty and complexity. Seven metal stents were implanted one by one using only endoscopic methods. Successful stent-in-stent placement and endoscopic ultrasound-guided stenting after failed ERCP improved the patient’s quality of life to the extent that there was no need for any external drainage.

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REFERENCES

• 김영롱(아주대학교 의과대학 감염내과) | Young Rong Kim (Department of Infectious Diseases, Ajou University School of Medicine, Suwon)
• 오치혁(경희대학교 의과대학 소화기내과) | Chi Hyuk Oh (Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul)
• 양민재(아주대학교 의과대학 소화기내과) | Min Jae Yang (Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea) Corresponding author