Endoscopic management of internally migrated pancreatic duct stents (with video)

Abstract

Endotherapy of PMPS could be complex and associated with adverse events. Level II-migrated stents may require specialized methods like pancreatoscopy for stent retrieval.

Adverse events associated with ERCP

“…Various techniques for removal of a proximally migrated stent have been described, including the use of stent retrieval devices, forceps, snares, or retrieval balloons. 162,163 Rarely, patients may require surgery to remove these migrated stents.…”

Endoscopic retrieval of two proximally migrated plastic pancreatic duct stents

“…1,2 While the distal stent migration into the duodenum is rarely of any clinical consequence as the stent is excreted uneventfully, proximal stent migration further into the PD results in obstructive pancreatitis. 1 Proximal migration of two stents, that too in the presence of ductal stricture, is very rare. 1,4,5 These proximally migrated stents pose a serious management dilemma, with many patients requiring surgical removal of the stents.…”

“…1 They are usually retrieved endoscopically using various techniques and accessories. 1 They are usually retrieved endoscopically using various techniques and accessories.…”

Successful retrieval of proximally migrated pancreatic duct stent by EUS-guided retrograde extrusion through the papilla

“…They are usually retrieved endoscopically using various techniques and accessories. [12] Endoscopic retrieval is usually successful in the majority of patients. [12] However, in some patients, repeated attempts to remove the migrated stent fail and these patients usually require surgery for the removal of migrated stent.…”

“…[12] Endoscopic retrieval is usually successful in the majority of patients. [12] However, in some patients, repeated attempts to remove the migrated stent fail and these patients usually require surgery for the removal of migrated stent. Various endoscopic alternatives including using pancreatoscopy to retrieve these stents have been suggested with varying success rates.…”