Cholangiopancreatography troubleshooting: the usefulness of endoscopic retrieval of migrated biliary and pancreatic stents.
BACKGROUND
Stent migration in the hepatopancreatic duct might arise as one of the rare complications associated with biliary or pancreatic stenting. Although there are some procedures to retrieve the migrated stent, including surgical, percutaneous, and endoscopic approaches, endoscopy should be attempted first because it is least invasive. This study set out to evaluate the usefulness of endoscopic retrieval of migrated biliary and pancreatic stents.


METHODS
Plastic stents that migrated in the bile duct (35 patients) or pancreatic duct (2) were retrieved with endoscopic retrograde cholangiopancreatography. Devices used were snare forceps, a basket catheter, grasping forceps, biopsy forceps, a balloon catheter, and the Soehendra stent retriever.


RESULTS
Endoscopic retrieval of migrated stents was performed successfully in 36 (97.0%) of the 37 patients. The devices utilized for successful treatment were basket catheter (13 patients), grasping forceps (10), snare forceps (8), balloon catheter (3), biopsy forceps (1), and the Soehendra stent retriever (1). The unsuccessfully treated patient with chronic pancreatitis underwent surgery since the guide wire did not move forward due to bile duct stenosis, and there was also duodenal stenosis. One patient developed mild pancreatitis after withdrawal of the stent; the pancreatitis was relieved with conservative treatment.


CONCLUSIONS
Endoscopic retrieval of migrated biliary and pancreatic stents appears to be useful because of its safety and low invasiveness. However, various forceps should be prepared for the retrieval of a migrated stent.
Sakai
Yuji
Y
Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan. sakai4754@yahoo.co.jp
Tsuyuguchi
Toshio
T
Ishihara
Takeshi
T
Sugiyama
Harutoshi
H
Eto
Reiko
R
Fujimoto
Tatsuya
T
Yasui
Shin
S
Tamura
Ryo
R
Togo
Seiko
S
Tada
Motohisa
M
Yokosuka
Osamu
O
D000368:Aged; D001652:Bile Ducts; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000295:instrumentation; D020878:Device Removal; D004867:Equipment Design; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging*; D010195:Pancreatitis / Q000209:etiology; D011474:Prosthesis Design; D018570:Risk Assessment; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome