Insertion of a duodenal stent using the ‘stent-in-stent’ method providing useful treatment for duodenal stenosis caused by progression of gastric cancer

A 51-year-old man complaining of abdominal distention was admitted to our hospital due to duodenal stenosis caused by progression of unresectable advanced gastric cancer. A duodenal self-expandable metallic stent was placed at the stenotic site. However, five months subsequent to this procedure, the duodenal stent was occluded because of tumor ingrowth. Two duodenal stents were inserted using the first ‘stent-in-stent’ method. Three months later the duodenal stents were again obstructed similarly. Another duodenal stent using the second ‘stent-in-stent’ method was inserted, which enabled restoration of the patient’s ability to eat and receive cancer chemotherapy. The ‘stent-in-stent’ method was used twice in this case, demonstrating this to be a useful procedure for duodenal stent occlusion and to significantly improve patient quality of life and dignity.