Biliary Stent Migration to Hepatic Duct–Case Report of a Late Complication

Alizadeh, Amir Houshang Mohammad; Donboli, Kianoush; Khodakarami, Mehran; Baghbani, Salar; Zali, Mohammad Reza

doi:10.4137/ccrep.s18975

Cited by 1 publication

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“…2 The rate of biliary stent migration is 4% to 10% and stent migration into proximal directions is rare event. 2 – 6 Still, the migrated stent may perforate the diaphragm, causing the subsequent formation of the BBF, presenting with such symptoms as biliptysis and severe bronchopneumonia. The aim of this study was to present a rare case of successful non-operative management of BBF in a patient with an unresectable Klatskin tumor.…”

Section: Introductionmentioning

confidence: 99%

Non-Operative Management of Bronchobiliary Fistula Due to Proximal Migration of Biliary Stent in a Patient With Unresectable Klatskin Tumor

Tsema

Slobodianyk²,

Rahushyn³

et al. 2021

Clin Med Insights Case Rep

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Introduction: One of the methods for the biliary tree decompression in the case of Klatskin tumor is transpapillary stenting, which could be completed by stent migration in 4% to 10% of cases. Approximately half of the stent migrations are in the proximal direction. In this study, we reported a rare case of proximal trans-diaphragmatic stent migration to the lower lobe of the right lung with the formation of a biliary-bronchial fistula (BBF). Case presentation: A 60-year-old woman was diagnosed with hilar cholangiocarcinoma (type 3B by Bismuth-Corlette) complicated by posthepatic jaundice. To relieve jaundice there were performed endoscopic retrograde cholangiopancreatography, endoscopic sphincterotomy, endobiliary stent placement (10 Fr, 150 mm). A restenting (11.5 Fr, 130 mm) was performed in 2.5 months due to endobiliary tube occlusion. In the next 2 months, coughing attacks and biliptysis have appeared in the patient. A CT scan showed penetration of the liver, diaphragm, and lower lobe of the right lung with the proximal part of the stent and caused BBF formation. Anti-inflammatory and antibacterial therapy was administrated for 14 days and BBF was closed. Stent retrieval from the right hemithorax and endobiliary restenting was performed in 9 months after primary stenting. During follow-up, appropriate positioning and functioning of the stent were observed. Conclusion: BBF formation is a rare complication of endobiliary stenting, which can be successfully treated by anti-inflammatory and antibiotic therapy, followed by transpapillary stent retrieval.

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Section: Introductionmentioning

confidence: 99%