title: Proximal migration of transanastomotic pancreatic stent following pancreaticoduodenectomy and pancreaticojejunostomy.
abstract: BACKGROUND
  The use of catheters to stent the pancreaticojejunal anastomosis following pancreaticoduodenectomy is practiced by some surgeons. Their long-term effects in this setting, however, remain unknown.
  
  
  METHODS
  A 60-yr-old woman underwent a potentially curative pylorus preserving pancreaticoduodenectomy for Stage I ampullary carcinoma. Roux-en-Y pancreaticojejunostomy was constructed over a short stent. She presented 4 yr later with abdominal pain, steatorrhea, and weight loss. Computed tomography revealed a stent within the proximal pancreatic duct, with gross upstream ductal dilatation and parenchymal features of chronic pancreatitis.
  
  
  RESULTS
  Laparotomy revealed no disease recurrence. The stent, removed through a jejunotomy, was occluded. On-table pancreatogram demonstrated a 3-cm proximal duct stricture. Drainage was achieved with a lateral pancreaticojejunostomy (modified Puestow procedure). Recovery was uneventful, with clinical recovery of pancreatic exocrine function at 6 mo follow-up.
  
  
  CONCLUSIONS
  Proximal migration of transanastomotic pancreatic stent with subsequent development of chronic pancreatitis is a potential complication following pancreaticoduodenectomy. It can be managed effectively with stent removal and a lateral pancreaticojejunostomy.
authors.affiliation: Department of Surgery, Dewsbury and District General Hospital, UK. Basil@ammori.freeserve.co.uk
authors.forename: B J
authors.initials: BJ
authors.lastname: Ammori
authors.forename: C M
authors.initials: CM
authors.lastname: White
mesh_terms: D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D010193:Pancreaticojejunostomy / Q000009:adverse effects*; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000209:etiology; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed