title: Migration of Internal Pancreaticojejunostomy Stents into the Bile Ducts in Patients Undergoing Pancreatoduodenectomy.
abstract: OBJECTIVE
  To investigate the incidence, complications, and risk factors of the migration of internal pancreaticojejunostomy (PJ) stents into the bile ducts in patients undergoing pancreatoduodenectomy.
  
  
  METHODS
  Postoperative computed tomography (CT) and clinical data of 802 patients with CT-detectable internal PJ stents were reviewed to assess the occurrence of stent migration into the bile ducts and stent-induced complications with their clinical significance. Risk factors for stent migration and stent-induced complications were determined.
  
  
  RESULTS
  Stent migration into the bile ducts occurred in 135 patients (16.8 %); 40 of these (29.6 %) showed stent-induced complications including bile duct stricture, stone, and liver abscess. Clinically significant complications were identified in only eight patients. Neither the stent length nor diameter was associated with stent migration. A small stent diameter, peripheral location of the stent, absence of stent remigration from the bile ducts to the intestine, and longer stent retention time in the bile ducts were risk factors of stent-induced complications.
  
  
  CONCLUSIONS
  The incidence of internal PJ stent migration into the bile ducts was 16.8 %. Migrated stents frequently caused complications, although they were mostly subclinical. Stent-induced complications were associated with stent diameter and location, stent remigration to the intestine, and stent retention time in the bile ducts.
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
authors.forename: So Hyun
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea. kimjhrad@amc.seoul.kr.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
authors.forename: Seung Yeon
authors.initials: SY
authors.lastname: Noh
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Byun
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
authors.forename: Seung Soo
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
authors.forename: Hyoung Jung
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
authors.forename: Sung Koo
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
authors.forename: Dae Wook
authors.initials: DW
authors.lastname: Hwang
authors.affiliation: Department of Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
authors.forename: Song Cheol
authors.initials: SC
authors.lastname: Kim
authors.affiliation: Department of Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
authors.forename: Duck Jong
authors.initials: DJ
authors.lastname: Han
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, South Korea.
authors.forename: Moon-Gyu
authors.initials: MG
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D055815:Young Adult
keywords: Bile ducts; Internal stent; Migration; Pancreaticojejunostomy; Pancreatoduodenectomy