Forgotten CBD stent (102 months) with stone-stent complex: A case report

Barai, Varsha; Hedawoo, Jagadish; Changole, Sanjay

doi:10.1016/j.ijscr.2016.11.048

Cited by 14 publications

(29 citation statements)

References 11 publications

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“…In patients with gallbladder stones, 10–15% of them will have concomitant CBD stones [1]. Rarely bile duct stones may form primarily as intrahepatic or extrahepatic stones without originating from the gallbladder.…”

Section: Discussionmentioning

confidence: 99%

Forgotten metal stent (3 years) presenting with a high burden of intra- and extra-hepatic ducts stones and cholangitis

Lesetedi

Motsumi

2019

Journal of Surgical Case Reports

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Forgotten stents may lead to serious complications. We present a case report of a forgotten common bile duct (CBD) fully covered metal stent presenting with recurrent cholangitis. A 79-years-old female patient presented with a history of recurrent cholangitis. Past surgical history was notable for open cholecystectomy for symptomatic cholelithiasis in 2016. Subsequently, she was found to have retained CBD stones in the same year. She had endoscopic retrograde cholangiopancreatography (ERCP), during which a complete clearance of the stone was not achieved and she was stented with a completely covered metal stent. She was lost to follow-up until 2019. A differential diagnosis of cholangitis secondary to a blocked stent was made. At ERCP, she had intra- and extra-hepatic stones, which could not be removed. A plastic stent was deployed. She later had an open bile duct exploration with Roux-en-Y hepaticojejunostomy. Forgotten stents can lead to serious complications. An electronic stent follow-up registry is recommended.

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Section: Discussionmentioning

confidence: 99%

Forgotten metal stent (3 years) presenting with a high burden of intra- and extra-hepatic ducts stones and cholangitis

Lesetedi

Motsumi

2019

Journal of Surgical Case Reports

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“…Stents retained for an extended period induce bacterial proliferation, biofilm formation, and release of bacterial beta‐glucuronidase. This leads to the precipitation of calcium bilirubinate, which is aggregated into stones by an anionic glycoprotein . SSC formation should be considered in patients with CBD stones having PS placement retained for more than 3 months.…”

Section: Discussionmentioning

confidence: 99%

“…SSC formation led to difficulties in removing the old stents with conventional endoscopic procedures and surgical intervention were required . Therefore, ESWL, electrohydrolic lithotripsy, laser lithotripsy, or mechanical lithotripsy, which are all effective in fragmenting large stones may be required as the optimal therapy in this situation.…”

Section: Discussionmentioning

confidence: 99%

“…Tang et al first focused on de novo stent–stone complex (SSC) formation, in which a biliary stent can act as a nidus for new biliary stone formation around the stent after long‐term placement, emphasizing that SSC formation should be recognized as one of the stent‐related complications. Several previous studies have also reported that following long‐term stent placement in patients, biliary stones develop either around the stent or cementing the stent, regardless of the presence or absence of CBD stones at the time of stenting . However, little is known about SSC formation in patients with CBD stones.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics and risk factors for stent–stone complex formation following biliary plastic stent placement in patients with common bile duct stones

Kaneko

Kawata

Watanabe

et al. 2018

J Hepato Biliary Pancreat

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Background Stent-stone complex (SSC) formation is one of the complications of endoscopic biliary stent placement. This study aimed to clarify the clinical characteristics and risk factors for SSC formation following plastic stent (PS) placement in patients with common bile duct (CBD) stones. Methods We retrospectively reviewed the charts of 78 patients with CBD stones who had undergone 107 biliary stent placements as palliative treatment. Demographic, historical, and stent-related data were collected and analyzed.Results At PS removal, SSC formations were observed in 18% of the 107 cases (SSC group) studied and not in the remaining 82% (non-SSC group). The duration of PS placement was significantly longer in the SSC group. The increase in CBD diameter during the stenting period as well as the incidence of cholangitis at PS removal was significantly greater in the SSC group. Multivariate analysis identified long-term (≥301 days) PS placement and the increase in CBD diameter during the stenting period as independent factors for SSC formation. Conclusions Long-term PS placement induces a risk of SSC formation in patients with CBD stones. The increase in diameter of CBD during the period of PS placement is a predictive factor for SSC formation in this situation.

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“…In the literature, the treatment methods varied and ranged from simple grasping forceps and a balloon catheter to the use of a cholangioscope, electro-hydraulic lithotripsy or extracorporeal shockwave lithotripsy, and multi-phase procedures. Reports even included cases in which the stent could not be removed, and the procedure was finished by implanting an additional stent [8] or performing surgical removal [9].…”

Section: Discussionmentioning

confidence: 99%

Successful Endoscopic Removal of a Biliary Stent with Stent-Stone Complex after Long-Term Migration

Morimachi

Ogawa

Yokota

et al. 2019

Case Rep Gastroenterol

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A 49-year-old man was referred to our hospital for an abnormality of the hepatobiliary enzyme. The patient was diagnosed with primary sclerosing cholangitis 9 years ago, and he had a biliary stent with a string placed as an inside stent. We attempted to remove the stent 6 months later, but the string was cut off, so the stent could not be removed. Removal was attempted again, but the patient cancelled the outpatient appointments. During the examination performed at the present visit, we discovered that the biliary stent had migrated into the bile duct, and a stone had formed around the stent. We attempted to remove the stent-stone complex by endoscopic retrograde cholangiopancreatography, but it was difficult; thus, we decided to implant a new biliary stent and remove the other stent later. When we performed endoscopic retrograde cholangiopancreatography again 2 days later, the bile duct axis was linearized thanks to the additional stent, enabling us to grab the migrated stent with stent-stone complex using grasping forceps and to successfully pull it out. By implanting an additional plastic stent temporarily, we were able to straighten the biliary axis and endoscopically remove the biliary stent that migrated and caused the development of stent-stone complex in a 2-staged approach.

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Forgotten CBD stent (102 months) with stone-stent complex: A case report

Cited by 14 publications

References 11 publications

Forgotten metal stent (3 years) presenting with a high burden of intra- and extra-hepatic ducts stones and cholangitis

Forgotten metal stent (3 years) presenting with a high burden of intra- and extra-hepatic ducts stones and cholangitis

Clinical characteristics and risk factors for stent–stone complex formation following biliary plastic stent placement in patients with common bile duct stones

Successful Endoscopic Removal of a Biliary Stent with Stent-Stone Complex after Long-Term Migration

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