# Case Report: Successful application of endoscopic biliary accessories in a patient with complete esophageal stricture

## TL;DR

This case report describes a successful endoscopic treatment for a complete esophageal stricture using biliary accessories, offering a new approach for managing severe esophageal blockages.

## Contribution

The paper introduces a novel endoscopic technique using biliary tools to treat refractory esophageal anastomotic stricture.

## Key findings

- Anterograde esophageal access was achieved using a biliary intubation method and a 0.35-inch guidewire.
- Biliary and balloon dilators were used to successfully dilate the complete esophageal stenosis.
- The patient's dysphagia was completely resolved following the procedure.

## Abstract

The endoscopic treatment of complete esophageal stricture presents a huge challenge. In instances where the esophageal lumen is nearly obliterated, preventing the passage of a dilating guide wire, conventional endoscopic bougie dilation is often difficult to perform. We report a case of patients with nearly complete esophageal stricture due to esophageal cancer surgery, leading to severe dysphagia and weight loss. Our strategy began with the achievement of anterograde esophageal access, facilitated by a biliary intubation method and aided by a 0.35-inch guidewire. Subsequently, we sequentially applied biliary dilators and balloon dilators, progressing along the guidewire to incrementally dilate the esophageal lumen up to the site of complete stenosis. The stenosis was successfully penetrated and dilated, and eventually the patient’s dysphagia was completely relieved. This case underscores the efficacy of the novel endoscopic treatment for biliary appendices in patients with refractory esophageal anastomotic stricture, offering a new therapeutic approach for clinical management.