Proximal migration of a biliary stent: what to do after failure of conventional and cholangioscopic retrieval techniques

Over-the-wire snare-assisted stent exchange in endoscopic retrograde cholangiopancreatography

“…Preserving the tract established by the stent facilitates the exchange and avoids challenges involved in negotiating tight strictures anew. Multiple methods have been described in the literature to facilitate this exchange, including the application of a dedicated metal stent retriever (eg, Soehendra device, Cook Medical, Bloomington, Ind, USA), 3 wire-guided dilation balloonassisted exchange, 4,5 and over-the-wire or next-to-thewire snare-assisted stent exchange. 1,2,6 These methods can be useful in multiple scenarios, including cases with challenging strictures, where there is a need to minimize contrast injection (eg, in a patient with a dominant stricture and primary sclerosing cholangitis), or where there is a need to regain access to an exact sectoral system (eg, a subphrenic abscess secondary to a peripheral biliary stricture).…”

“…Preserving the tract established by the stent facilitates the exchange and avoids challenges involved in negotiating tight strictures anew. Multiple methods have been described in the literature to facilitate this exchange, including the application of a dedicated metal stent retriever (eg, Soehendra device, Cook Medical, Bloomington, Ind, USA), 3 wire-guided dilation balloon-assisted exchange, 4 , 5 and over-the-wire or next-to-the-wire snare-assisted stent exchange. 1 , 2 , 6 …”