General description of endoscopic technique
EBD failure, stenosis, Dilation failure
DILATION, STENOSIS
The type of endoscopic treatment will be EBD initially, and FCSEMS will be placed as a rescue endoscopic treatment if EBD failure occurs.EBD treatment:Post-procedural admission in the short stay unit (SSU).Superficial sedation by endoscopist or anesthesiologist depending on the centre.Pneumatic balloon type: a CRE Boston scientific® (Marlborough, MA, USA) pneumatic balloon (CRE Wireguided Esophageal, Pyloric, Colonic, 8–20 mm; Cork, Ireland); diameter of the balloon at the endoscopist’s discretion.A maximum of 2 sessions of dilation will be performed with a minimum interval of 15–30 days between them.Dilation failure will be considered if more than 2 sessions of dilation are required.FCSEMS treatment:Post-procedural admission to the SSU.Superficial sedation by endoscopist or anesthesiologist depending on the centre.FCSEMS type: a 22-diameter Taewoong fully covered, self-expandable metal stent (Niti-S S Enteral Colonic Stent, 6–10 cm; Gimpo-si, South Korea). The stent length will be set at the discretion of the endoscopist (at least 1.5 cm for each edge of the stenosis is necessary to ensure a successful procedure).To fix the stent. clips may be placed at the distal end of the stent at the endoscopist’s discretion.Maximum removal time of the stent will be 4 weeks, if spontaneous migration has not occurred.