Complications and treatment of migrated biliary endoprostheses: A review of the literature

Abstract

Endoscopic biliary stent insertion is a well-established procedure. It is especially successful in treating postoperative biliary leaks, and may prevent surgical intervention. A routine change of endoprostheses after 3 mo is a common practice but this can be prolonged to 6 mo. We reported a colonic perforation due to biliary stent dislocation and migration to the rectosigmoid colon, and reviewed the literature.

A Potentially Fatal Complication of Biliary Stent Migration

“…The most common complication of a biliary stent is blockage of the stent due to biliary sludge or tumour ingrowth with resulting recurrent obstructive jaundice and cholangitis [1]. Stent migration is another significant complication.…”

“…It has been postulated that diverticulosis of the colon may increase the risk of perforation of the colon due to a migrated stent becoming impacted in a diverticulum [10]. Other co-morbidities that could lead to stent impaction and subsequent perforation include abdominal hernias and intra-abdominal adhesions [1].…”

“…Usually in such cases a delayed x-ray will be undertaken to ensure the stent has successfully been extruded. There have been reported cases of multiple complications due to migrated stents including bowel perforation [1], intraabdominal abscesses [6], fistula formation [7] and bowel obstruction [8].…”

“…A review of the literature in 2007 identified 11 cases of colonic perforation due to migrated stents [1]. It has been postulated that diverticulosis of the colon may increase the risk of perforation of the colon due to a migrated stent becoming impacted in a diverticulum [10].…”

Dislodged biliary stent causes lower gastrointestinal hemorrhage four years postendoscopic retrograde cholangiopancreatography

“…Time to plastic biliary stents migration ranges from 2 weeks to 3 years post‐ERCP 1. Stent colonic impaction may arise due to diverticular disease, while hemorrhage results from stent‐induced mucosal injury 2.…”