title: Proximally migrated pancreatic stent successfully removed using needle-knife and forceps: complication after precut papillotomy assisted by pancreatic stenting.
abstract: Pancreatic stent-assisted ampullary precut papillotomy is a rescue method for cases with difficult bile duct cannulation during endoscopic retrograde cholangiopancreatography (ERCP). We describe a case in which post-ERCP pancreatitis (PEP) developed due to the proximal migration of pancreatic stent, after precut papillotomy. Removal of the migrated pancreatic stent was achieved after needle-knife incision of the pancreatic duct's orifice followed by retrieval of the stent using rat-tooth forceps, which resulted in rapid resolution of the PEP. Caution is needed when pancreatic stent is placed after papillary incision. Needle-knife incision of the pancreatic duct orifice followed by forceps removal is an effective technique for rescuing pancreatic stent migration.
authors.affiliation: Division of Endoscopy, Shizuoka Cancer Center, Suntogun, 1007 Shimonagakubo, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan. h.matsubayashi@scchr.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsubayashi
authors.forename: Shohei
authors.initials: S
authors.lastname: Ooka
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kimura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sawai
authors.forename: Naomi
authors.initials: N
authors.lastname: Kakushima
authors.forename: Masaki
authors.initials: M
authors.lastname: Tanaka
authors.forename: Michael
authors.initials: M
authors.lastname: Goggins
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ono
mesh_terms: D000368:Aged; D020878:Device Removal / Q000295:instrumentation*; D005260:Female; D005548:Foreign-Body Migration / Q000601:surgery*; D006801:Humans; D009339:Needles; D011475:Prosthesis Failure; D016717:Sphincterotomy, Endoscopic; D015607:Stents / Q000009:adverse effects*