Removal of transanastomotic pancreatic stent tubes after pancreaticoduodenectomy: a new role for double-balloon enteroscopy.
BACKGROUND
Endoscopic interventions are usually very challenging in patients with anatomic changes caused by earlier GI surgery. The recent development of the double-balloon enteroscopy (DBE) system creates an opportunity to reach the biliary tract and the pancreatic duct in postsurgical conditions.


OBJECTIVE
To report a further application of DBE in surgical patients; namely, extraction of pancreatic stents placed in pancreaticojejunal anastomosis during pancreaticoduodenectomy.


METHODS
Two case reports.


METHODS
A single-center experience in a tertiary-care unit.


METHODS
Two patients who underwent Whipple resection with Roux-en-Y reconstruction presented with migration of pancreatic stent tubes inserted in pancreaticojejunal anastomoses. Stents had migrated to the end of the afferent limb and were causing abdominal pain. Because extraction failed by using conventional endoscopy, we used the DBE system.


METHODS
Successful extraction of the stents.


RESULTS
Stents were successfully removed in both patients with no complications. After 1 year of follow-up, the patients remained free of painful symptoms.


CONCLUSIONS
Small volume case series.


CONCLUSIONS
Double-balloon enteroscopy is a reliable way to investigate and treat patients with postsurgical altered anatomy. Here, we report the successful removal of pancreatic stents migrating into the jejunal loop through pancreaticojejunal anastomosis.
Layec
Sabrina
S
Service des maladies de l'appareil digestif, Centre hospitalo-universitaire, Rennes, France.
D'Halluin
Pierre-Nicolas
PN
Pagenault
Mael
M
Sulpice
Laurent
L
Meunier
Bernard
B
Bretagne
Jean-François
JF
D000328:Adult; D002404:Catheterization / Q000295:instrumentation*; D020878:Device Removal / Q000379:methods*; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000295:instrumentation; D011475:Prosthesis Failure; D012086:Reoperation; D015607:Stents; D014057:Tomography, X-Ray Computed