Endotherapy for severe and complete pharyngo-esophageal post-radiation stenosis using wires, balloons and pharyngo-esophageal puncture (PEP) (with videos)

Shou Jiang Tang, Shailender Singh, John M. Truelson

Research output: Contribution to journalArticle

8 Scopus citations


Background: Pharyngo-esophageal stenosis (PES) and upper esophageal stricture are common in patients who receive radiation therapy for laryngeal and hypopharyngeal cancers. In severe or complete stenosis, the patients generally have complete dysphagia with inability to swallow their saliva. Diagnostic and therapeutic esophagogastroduodenoscopy (EGD) plays an important role in investigating the dysphagia and in managing the underlying stenosis. Methods and Results: We translate endoscopic retrograde cholangiopancreatography (ERCP) techniques and skills in approaching pancreaticobiliary obstruction in the management of severe and complete PES. We select and report three cases of severe or complete PES in which flexible endoscopic therapy was successfully provided by using fluoroscopy, ERCP wire guides, endoscopic balloons, and by performing pharyngo-esophageal puncture (PEP). Conclusions: We propose the term PEP in managing complete PES. We believe this approach can offer safety and efficiency with very high success rate.

Original languageEnglish (US)
Pages (from-to)210-214
Number of pages5
JournalSurgical endoscopy
Issue number1
Publication statusPublished - Jan 2010



  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Esophagogastroduodenoscopy
  • Esophagus
  • Pharyngo-esophageal puncture (PEP)
  • Radiation therapy
  • Stricture

ASJC Scopus subject areas

  • Surgery

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