Case History

A 78‐year‐old woman was referred to our surgical department for functional staging prior to potential operative management of a long‐segment esophageal stricture. The stenosis had initially been classified as benign and peptic in origin and has been repeatedly treated by endoscopic bougienage at an external institution without sustained clinical success. At presentation, the patient reported progressive dysphagia, restricted to liquid intake, and marked involuntary weight loss of approximately 30 kg over the preceding two years.

Her medical history was further complicated by intra‐ and extrahepatic cholestasis secondary to choledocholithiasis, for which a common hepatic duct stent had been placed previously. Definitive biliary sanitation via endoscopic retrograde cholangiopancreatography (ERCP) has not been achieved due to the inability to traverse the esophageal stenosis endoscopically. Initial preoperative risk assessment revealed severe obstructive pulmonary disease (FEV1 at 0.87 L), rendering the patient unsuitable for immediate surgical intervention. The patient was therefore transferred to our gastroenterological department for conservative therapy.