title: Biliary sphincteroplasty facilitates retrieval of proximally migrated plastic biliary stent.
abstract: OBJECTIVE
  Proximal migration of biliary stents presents a technical challenge for the therapeutic endoscopist. It may require multiple, complicated corrective procedures resulting in significant morbidity to the patients. In this study we evaluated the utility of balloon biliary sphincteroplasty with CRE (Controlled Radial Expansion) Balloon Dilator on retrieval of proximally migrated biliary stents.
  
  
  METHODS
  We identified patients from our ERCP database who presented with proximal migration of biliary stent, between August 2011 and October 2013. Patients in whom the stent could not be retrieved with conventional methods, balloon sphincteroplasty was performed with a 12 mm CRETM Balloon Dilator (Boston Scientific). Stent removal was attempted with extraction balloon or basket thereafter.
  
  
  RESULTS
  We identified 28 patients with proximal migration of biliary stents, placed for benign diseases of the common bile duct. Stent removal was successful in 18 patients (64.28%) with help of an extraction balloon or basket. Of the remaining 10 patients, balloon sphincteroplasty was successfully followed by stent removal in eight patients.
  
  
  CONCLUSIONS
  Balloon biliary sphincteroplasty increases the success rate of retrieving proximally migrated biliary stents. The procedure is safe, technically easy and yields a good success rate in our experience.
authors.forename: Dharmesh K
authors.initials: DK
authors.lastname: Shah
authors.forename: Samit S
authors.initials: SS
authors.lastname: Jain
authors.forename: Piyush O
authors.initials: PO
authors.lastname: Somani
authors.forename: Pravin M
authors.initials: PM
authors.lastname: Rathi
mesh_terms: D000328:Adult; D001652:Bile Ducts / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D020878:Device Removal / Q000379:methods*; D004106:Dilatation / Q000379:methods; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D005548:Foreign-Body Migration / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome