A novel tapered plastic stent with an ultrafine delivery system for one-step endoscopic ultrasound-guided hepaticogastrostomy.

A 76-year-old woman was admitted to our hospital with obstructive jaundice due to pancreas head cancer ([Fig. 1]). Endoscopic transpapillary biliary drainage was attempted but was unsuccessful owing to duodenal invasion. We therefore tried one-step endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) using a novel stent system (Crane stent; SB-Kawasumi, Kanagawa, Japan). The stent system comprises a straight-type, 7-Fr, plastic stent with a tapered tip of 4.7 Fr, an inner catheter with an extremely fine 2.5-Fr tip designed for use with a 0.025-inch guidewire, and a pusher connected to the stent allowing it to be pulled back ([Fig. 2]). A stent with a length of 15 cm between the flaps was selected.