Removal of a biliary self‐expandable metal stent using the zipline technique for pancreatic cancer with duodenal stricture

AN 81‐YEAR‐OLD MAN with advanced pancreatic head cancer was admitted to our hospital due to nonocclusion cholangitis. He had previously received a fully covered self-expandable metal stent (SEMS) for malignant biliary obstruction. We inserted a duodenoscope into the duodenum, but failed to visualize the SEMS endoscopically due to type II duodenal obstruction. We also failed to grasp the SEMS under fluoroscopy using a rat tooth forceps or a