title: Removal of transanastomotic pancreatic stent tubes after pancreaticoduodenectomy: a new role for double-balloon enteroscopy.
abstract: 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.
authors.affiliation: Service des maladies de l'appareil digestif, Centre hospitalo-universitaire, Rennes, France.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Layec
authors.forename: Pierre-Nicolas
authors.initials: PN
authors.lastname: D'Halluin
authors.forename: Mael
authors.initials: M
authors.lastname: Pagenault
authors.forename: Laurent
authors.initials: L
authors.lastname: Sulpice
authors.forename: Bernard
authors.initials: B
authors.lastname: Meunier
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bretagne
mesh_terms: 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