Endoscopic Retrieval of Migrated Plastic Stent Into Bile Duct or Pancreatic Pseudocyst

Abstract

Proximally migrated biliary plastic stent and migrated stent in the pancreatic pseudocyst are relatively rare complications. A migrated stent causes poor drainage conditions, which leads to secondary complications such as infection, abscess, perforation and, moreover, becomes a foreign object in the body, and retrieval or re-stenting is therefore necessary. The retrieval of a migrated stent includes surgical, percutaneous and endoscopic approaches, and the most non-invasive method is endoscopic retrieval. However, because very few devices are exclusively designed for retrieval, the current situation is that the available devices are used while taking advantage of various ideas and techniques. From previously reported cases and our experiences of such cases, we herein describe the methods of endoscopic retrieval for stents that have migrated into a bile duct or pancreatic pseudocysts.

Walled-off pancreatic necrosis

“…If pancreatic infection is suspected, fine needle aspiration should be performed. Today, WOPN is a well accepted indication for open surgery, when minimal invasive treatment is not efficient [60] . Natural orifice translumenal endoscopic surgery (NOTES) has emerged as an innovation in endoscopic access that allows incisionless surgery.…”

Endoscopic retrieval of a migrated biliary stent into intrahepatic bile duct by using fine‐gauge biliary balloon dilation catheter

“…The frequency of migration of stents into bile duct has been reported to be 1.7–10% 1–3 . Okabe et al 4 . reported that some devices were effective to remove a migrated stent.…”

“…T HE FREQUENCY OF migration of stents into bile duct has been reported to be 1.7-10%. [1][2][3] Okabe et al 4 reported that some devices were effective to remove a migrated stent. However, it has been unknown that the frequency of migration of stents in patients with surgically altered anatomy.…”

Removal of a migrated biliary stent using new digital cholangioscopy retrieval devices in a transplant patient

“…by the SpySnare (Boston Scientific) ( ▶ Fig.3), and the migrated stent was totally extracted (▶ Video 1). Proximal migration of biliary stents occurs in around 5 % of ERCP procedures, despite the antimigratory design of the stents [3]. Although in most cases extraction is possible, it may be challenging and technically difficult.…”