title: [Proximal migration of biliary prosthesis. Endoscopic extraction techniques].
abstract: BACKGROUND
  Proximal migration of a biliary stent is an uncommon event, but its management can present a technical challenge to the therapeutic endoscopist.
  
  
  OBJECTIVE
  We reviewed the methods that have been used for retrieval of proximally migrated biliary stents in a referral endoscopic center. PATIENTS-METHOD, AND RESULTS: From January 1995 to December 1998, there were 410 procedures for insertion of biliary stents. Eighteen patients had migrated biliary stents; 15 stents (83%) were extracted successfully. One half of the stents were retrieved by grasping the stent directly with a wire basket. Four were recovered using the Soehendra device, and a stone retrieval balloon alongside the stents to provide traction indirectly in two patients. Surgical techniques were necessary in three cases.
  
  
  CONCLUSIONS
  In patients with a dilated duct, indirect traction with a balloon or direct grasping of the stent with a wire basket is usually successful. Cannulating the stent lumen with a wire is often the best approach in patients with biliary stricture or nondilated duct. Using these techniques, most proximally migrated biliary stents can be retrieved endoscopically.
authors.affiliation: Departamento de Endoscopia Digestiva, Hospital de Especialidades No 71, IMSS, Blvd. Revolución y Calle No 26, C.P. 27000, Torreón, Coahuila.
authors.forename: G
authors.initials: G
authors.lastname: Alfredo
authors.forename: A
authors.initials: A
authors.lastname: Raúl
authors.forename: R
authors.initials: R
authors.lastname: Barinagarrementeria
authors.forename: J A
authors.initials: JA
authors.lastname: Gutiérrez-Bermúdez
authors.forename: J
authors.initials: J
authors.lastname: Martínez-Burciaga
mesh_terms: D001652:Bile Ducts / Q000601:surgery*; D016145:Endoscopy, Digestive System; D005548:Foreign-Body Migration / Q000601:surgery*; D006801:Humans; D011475:Prosthesis Failure