Distal Biliary Stent Migration in Patients with Irretrievable Bile Duct Stones: Long-Term Comparison Between Straight and Double-Pigtail Stents

Paspatis, Grigorios; Papastergiou, Vasilios; Mpitouli, Afroditi; Velegraki, Magdalini; Nikolaou, Pinelopi; Fragkaki, Maria; Voudoukis, Evangelos; Theodoropoulou, Anǵeliki; Chlouverakis, Gregorios; Vardas, Emmanouil; Paraskeva, Konstantina

doi:10.1007/s10620-022-07461-4

Cited by 7 publications

(15 citation statements)

References 21 publications

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“…7,8 A retrospective study in 2022 revealed that in cases in which the stent was retained for an extended duration, distal stent migration was more commonly observed with double-pigtail versus straight stents. 9 Among the adverse events associated with biliary stenting, stent-induced duodenal wall injuries are rare. A retrospective study conducted in 2020 investigated 25,224 ERCP procedures and identified duodenal perforations in 11 patients (0.04%).…”

Section: Discussionmentioning

confidence: 99%

Penetration of duodenal wall by proximal end of biliary straight plastic stent in a patient with ampullary carcinoma

Takahashi,

Ohyama,

Takiguchi

et al. 2024

DEN Open

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A 70‐year‐old woman presented to our hospital with abdominal discomfort. Gastrointestinal endoscopy revealed an ampullary tumor, while a biopsy revealed a pathological diagnosis of adenocarcinoma. No distant metastases were observed and neoadjuvant chemotherapy and surgical resection were planned. Shortly thereafter, she developed obstructive jaundice due to the ampullary carcinoma. The patient underwent endoscopic retrograde cholangiopancreatography, during which a straight plastic stent was placed in the bile duct. The patient was discharged without complications. Neoadjuvant chemotherapy was initiated. Two months later, she was readmitted for surgery while asymptomatic. Endoscopic retrograde cholangiopancreatography was scheduled to replace the stent with a nasobiliary drainage tube for the surgery. Endoscopic imaging revealed that the proximal end of the stent had penetrated the duodenum on the oral side of the ampullary carcinoma. The distal end of the stent was grasped with forceps and the stent was successfully removed. A catheter was inserted into the bile duct orifice and cholangiography was performed, which revealed that the distal bile duct and the duodenum had formed a fistula. A guidewire was placed in the bile duct via the papilla and a nasobiliary drainage tube was placed. After endoscopic retrograde cholangiopancreatography, the patient exhibited smooth progress without issue. Pancreaticoduodenectomy was performed on the fourth day after the nasobiliary drainage tube placement, and the patient's postoperative course was uneventful. The proximal end of a biliary stent penetrating the duodenal wall is an infrequent phenomenon. This case report highlights a rare but noteworthy adverse event associated with straight biliary plastic stent placement.

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Section: Discussionmentioning

confidence: 99%

Penetration of duodenal wall by proximal end of biliary straight plastic stent in a patient with ampullary carcinoma

Takahashi,

Ohyama,

Takiguchi

et al. 2024

DEN Open

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“…The almost exclusive causation of colonic and duodenal perforations by straight plastic stents should be kept in mind when choosing a biliary stent, and risk factors of stent migration should be considered. Whether reported higher rates of migration in pigtail stents 3 is compensated for by less complications from perforation remains unclear. Consequent follow-up of implanted stents until their removal or excretion is documented should be assured by keeping records of implanted stents.…”

Section: Discussionmentioning

confidence: 99%

“…Biliary stenting is a common procedure to treat a variety of benign and malignant conditions, most notably common bile duct stones, acute cholangitis, and benign or malignant strictures of the common bile duct. Stent migration occurs in 3%-21% [1][2][3][4][5] of patients, the rate being highly dependent on the etiology of the stricture, stent type used, and length of follow-up. Although stent migration is not uncommon, serious complications due to this are rare.…”

Section: Introductionmentioning

confidence: 99%

The Pierced Colon: When Biliary Stents Go the Wrong Way

Rybinski¹,

Heinrich²,

Zimmerli³

et al. 2023

ACG Case Rep J

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Bowel perforation of biliary stents is a rare complication of biliary stenting. We report the successful endoscopic treatment of a 78-year-old man with a straight biliary plastic stent perforating the ascending colon without underlying structural abnormality in the affected segment. Perforation was detected incidentally during computed tomography; the patient had been under continued antibiotic therapy for liver abscess. Stent extraction was performed by using an endoscopic snare; the site of perforation was closed with through-the-scope clips. The patient remained asymptomatic. In addition, we reviewed published cases of perforated biliary stents and outlined that most perforations are caused by straight plastic stents.

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“…Endoscopic treatment using balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP) is useful for hepaticojejunostomy anastomotic strictures. Although biliary stent placement is conducted to avoid stricture recurrence or realize stricture resolution after balloon dilation 1 2 , distal stent migration is a common problem 3 4 .…”

Section: Endoscopy E-videosmentioning

confidence: 99%

Use of a novel biliary stent to prevent distal stent migration in benign anastomotic stricture

et al. 2023

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Distal Biliary Stent Migration in Patients with Irretrievable Bile Duct Stones: Long-Term Comparison Between Straight and Double-Pigtail Stents

Cited by 7 publications

References 21 publications

Penetration of duodenal wall by proximal end of biliary straight plastic stent in a patient with ampullary carcinoma

Penetration of duodenal wall by proximal end of biliary straight plastic stent in a patient with ampullary carcinoma

The Pierced Colon: When Biliary Stents Go the Wrong Way

Use of a novel biliary stent to prevent distal stent migration in benign anastomotic stricture

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