Osteomyelitis as a Result of Pancreaticojejunostomy Stent Migration after Whipple Procedure

Munis, Assad; Solomon, Brad; Mazulis, Andrew; Laurie, Timothy

doi:10.14309/crj.2018.67

Cited by 4 publications

(4 citation statements)

References 12 publications

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“…Migration of these internal stent has been reported with serious consequences 7,8 . Kadowaki et al 7 reported acute pancreatitis in two patients with stent remaining in pancreatic duct and acute cholangitis in one patient with stent migrated into the bile duct.…”

Section: Discussionmentioning

confidence: 99%

“…Migration of these internal stent has been reported with serious consequences. 7,8 Kadowaki et al 7 reported acute pancreatitis in two patients with stent remaining in pancreatic duct and acute cholangitis in one patient with stent migrated into the bile duct. Munis et al 8 reported a case of osteomyelitis as a complication from an entero-spinal fistula secondary to a migrated stent placed at PJ after partial degradation.…”

Section: Discussionmentioning

confidence: 99%

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Initial experience with a novel biodegradable pancreatic stent in pancreatoduodenectomy

Yuen

Chan²,

Luk³

et al. 2022

Surgical Practice

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The application of biodegradable pancreatic stent in pancreatoduodenectomy has rarely been studied. Archimedes biodegradable stent is a newly designed CE‐approved biodegradable stent. We conducted a retrospective cohort study to evaluate the performance of this stent in patients undergoing pancreatoduodenectomy. Clinical outcomes of these patients were reviewed. Among nine patients in this study, six (66.7%) slow‐degrading, two (22.2%) medium‐degrading, and one (11.1%) fast‐degrading stents were used. Technical success rate was 100%. There was no hospital mortality. Four patients (44.4%) developed clinically relevant post‐operative pancreatic fistula (POPF). Proximal migration of stent occurred in two patients (22%) who were managed conservatively. Five stents (55.5%) degraded within the expected degradation period. In conclusion, the use of Archimedes biodegradable stent in pancreatoduodenectomy is technically feasible. Future study is needed to evaluate its potential efficacy of reducing POPF.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Initial experience with a novel biodegradable pancreatic stent in pancreatoduodenectomy

Yuen

Chan²,

Luk³

et al. 2022

Surgical Practice

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“…Pancreaticoduodenectomy is a high-risk surgical procedure performed by removing the duodenum, the head of the pancreas, the gallbladder, and the bile duct [9]. A critical part of the procedure is the formation of the pancreatico-enteric anastomosis [10]. Therefore, a stent is usually sited to ensure healing of the anastomosis site and to reduce the risk of formation of a postoperative pancreatic fistula.…”

Section: Discussionmentioning

confidence: 99%

Retrograde Pancreatic Duct Stent Migration into the Biliary Tract Presenting as a Rare Early Complication of Pancreaticoduodenectomy (Whipple Procedure)

et al. 2019

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Unusual or unexpected effect of treatment Background: Pancreaticoduodenectomy (Whipple procedure) is an established surgical procedure for the treatment of carcinoma of the head of the pancreas. Modifications to this procedure include gastropancreaticoduodenectomy, which includes the removal of parts of the pancreas, duodenum, and stomach. Complications of surgery include fistula formation, failure of the anastomosis, and leak of pancreatic enzymes, which can be reduced by stenting the pancreatic duct. This report is of a rare complication of pancreaticoduodenectomy and describes a case of retrograde migration of a pancreatic duct stent into the biliary tract through the orifice of the hepaticojejunostomy. Case Report: A 50-year-old man with a history of gastric cancer, underwent gastropancreaticoduodenectomy. Surgery was complicated by displacement of the pancreatic stent to the biliary system, which resulted in postoperative obstructive jaundice and bile leakage from the hepaticojejunostomy between the hepatic duct and the jejunum. An endoscopy was performed and the stent was successfully retrieved. The patient recovered rapidly, the bile leakage resolved, the patient's jaundice resolved, and was discharged home with no further surgical complications. Conclusions: A case is reported of a rare early complication of pancreaticoduodenectomy in a patient with gastric cancer. Endoscopy successfully retrieved the pancreatic duct stent that had migrated into the biliary tract through the orifice of the hepaticojejunostomy.

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“…Stent migration is a rare complication documented in case series and can result in biliary colic, cholangitis, hepatic abscesses, and even osteomyelitis. 4 – 7 In this patient, the migrated pancreatic stent lodged within the choledochojejunostomy and served as a nidus for stone formation, causing cholangitis. Performing an endoscopic retrograde cholangiopancreatography in patients with pancreaticoduodenectomy anatomy can be challenging but is usually successful with a pediatric colonoscope, as in our patient, or balloon-assisted enteroscopy.…”

Section: Case Reportmentioning

confidence: 99%

Cholangitis Caused by a Migrated Pancreatic Duct Stent Into the Bile Duct After Pancreaticoduodenectomy

et al. 2020

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Osteomyelitis as a Result of Pancreaticojejunostomy Stent Migration after Whipple Procedure

Cited by 4 publications

References 12 publications

Initial experience with a novel biodegradable pancreatic stent in pancreatoduodenectomy

Initial experience with a novel biodegradable pancreatic stent in pancreatoduodenectomy

Retrograde Pancreatic Duct Stent Migration into the Biliary Tract Presenting as a Rare Early Complication of Pancreaticoduodenectomy (Whipple Procedure)

Cholangitis Caused by a Migrated Pancreatic Duct Stent Into the Bile Duct After Pancreaticoduodenectomy

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