Duodenal perforation as a consequence of biliary stent migration can occur regardless of stent type or duration

Intraperitoneal duodenal perforation secondary to early migration of biliary stent: closure with through-the-scope clip

“…Conversely, they can be complicated by the development of bilioma or abscess, manifesting with fever, abdominal pain or overt septic shock 7. Only a few cases of stent-related intraperitoneal duodenal perforations have been described in the literature 6 8. Intraperitoneal perforations usually carry a worse prognosis, especially in case of delayed diagnosis and consequent biliary peritonitis 6.…”

Adverse events associated with ERCP

“…Luminal perforation has been reported following migration of plastic and metal stents, 140 and no particular stent is considered higher risk than another. The treatment for stent-induced perforation is endoscopic removal and endoscopic closure of the perforation if the patient does not have clinical features of peritonitis.…”

“…Surgical management is appropriate for patients with peritonitis or a retroperitoneal fluid collection. 140…”

SpyCatcher: Use of a Novel Cholangioscopic Snare for Capture and Retrieval of a Proximally Migrated Biliary Stent

“…Proximal or distal migration of plastic biliary stents has been reported in 5–10% of patients [1]. Distal biliary stent migration may result in recurrent biliary obstruction, cholangitis, or bowel perforation [2–4]. Proximal biliary stent migration may result in pain/biliary colic, bile duct wall injury with resultant stricture formation, or deposition of stone debris around the stent [2, 3].…”