Post ERCP Migration of Biliary Stent Through Common Bile Duct Wall - A Case Report

Biliary stent migration: why, how, and what?

“…In the current study, stent migration was associated with inadequate biliary drainage or with stent obstruction hence the commonest secondary complication was cholangitis. Because we did not report extraluminal migrations we did not have life-threatening complications like major bleeding, major perforations or peritonitis similar to what reported in the previously described case reports [6][7][8][9][10][11][12][13][14][15]. Although the minor bleeding due to duodenal erosions and small duodenal perforations reported in this study were easily managed by conservative means and endoscopic clipping, respectively.…”

“…However when this fails interventional radiology or surgery may be required [16,25]. Furthermore, complicated cases with major perforations are inevitably surgically managed [7][8][9][10][11][12][13][14][15]25].…”

“…The diagnostic methods to confirm biliary stent migrations include X-ray imaging, computed tomography (CT) scans, endoscopy, and even laparoscopy and laparotomy [4,14,15]. Although, management of biliary stent migration most of the time is carried out by endoscopic techniques with success rates up to 86% [16], different case reports reported different complications for both stent retrieval and management of migration-related complications and different invasive techniques including laparoscopy and surgery were sometimes inevitable [6][7][8][9][10][11][12][13][14][15].…”

“…Stents migrate either proximally to within the CBD and the liver or distally out of the CBD and duodenal papilla. Furthermore, the ectopic sites of stent migration include the lateral wall of the CBD [7], peritoneal cavity [8,9], pleura and lung [10], the gall bladder [11], the stomach [12], the colon [13] and the appendix. It is sometimes associated with life-threatening complications, for example, perforation, bleeding and peritonitis [4,14,15].…”

Delayed Hemobilia Caused by Penetration of Biliary Plastic Stent into Portal Vein

“…The migrated stent was surgically removed and primary repair of CBD penetration was performed. 10 In this case, the biliary plastic stent was rotated in opposite direction against to the CBD angulation probably due to traction of endoscope during duodenal metal stenting procedure. Contrary to distal tip of biliary stent fixed by duodenal angulation and metal stent, its proximal tip could stab the angulated portion of CBD by repetitive endoscopic exam in the period of stenting procedure.…”