Retroperitoneal Perforation Caused by Migration of a Pancreatic Spontaneous Dislodgement Stent into Periampullary Diverticula

Nishiwaki, Masatake; Mizuno, Chiemi; Yano, Kota; Oya, Hirohisa; Amano, Ichiro; Matsumoto, Junko; Tanaka, Izumi; Sawai, Naoki; Mizuno, Masayuki; Shima, Toshihide; Miyamoto, Yoshiharu; Okanoue, Takeshi

doi:10.2169/internalmedicine.9054-17

Cited by 10 publications

(5 citation statements)

References 12 publications

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“…Stents can be used for management of various entities, including malignant biliary strictures, large obstructing bile duct or pancreatic duct stone burden, benign biliary or pancreatic duct strictures, bile leak, papillary stenosis, pseudocyst drainage, and prevention of post-ERCP pancreatitis. Migration of a biliary stent is a known potential complication of ERCP, with distal migration occurring in 4 % to 6 % of cases [1,2].Perforation of the duodenal wall opposing the major papilla due to a migrated pancreatobiliary stent has been described previously in the literature as a complication of ERCPnearly universally in case reports [3][4][5][6][7][8][9][10][11][12][13][14][15]. From all accounts, it is a rare complication, yet the adverse outcome from a duodenal perforation can be devastating.…”

mentioning

confidence: 99%

A Rare Complication of ERCP: Duodenal Perforation Due to Biliary Stent Migration

Gromski

Bick

Easler

et al. 2017

American Journal of Gastroenterology

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Placement of pancreatobiliary stents during endoscopic retrograde cholangiopancreatography (ERCP) is a common practice. Stents can be used for management of various entities, including malignant biliary strictures, large obstructing bile duct or pancreatic duct stone burden, benign biliary or pancreatic duct strictures, bile leak, papillary stenosis, pseudocyst drainage, and prevention of post-ERCP pancreatitis. Migration of a biliary stent is a known potential complication of ERCP, with distal migration occurring in 4 % to 6 % of cases [1,2].Perforation of the duodenal wall opposing the major papilla due to a migrated pancreatobiliary stent has been described previously in the literature as a complication of ERCPnearly universally in case reports [3][4][5][6][7][8][9][10][11][12][13][14][15]. From all accounts, it is a rare complication, yet the adverse outcome from a duodenal perforation can be devastating. Factors associated with perforation from migrated stents are unknown. Furthermore, the incidence rate of this complication is also not currently appreciated.The primary aims of this study were to describe cases of duodenal perforation from migrated pancreatobiliary stents and to identify potential risk factors that may lead to perforation.

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mentioning

confidence: 99%

A Rare Complication of ERCP: Duodenal Perforation Due to Biliary Stent Migration

Gromski

Bick

Easler

et al. 2017

American Journal of Gastroenterology

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“…Perforation of the duodenal wall opposing the major papilla due to a migrated pancreatobiliary stent has been described previously in the literature as a complication of ERCP – nearly universally in case reports 3 4 5 6 7 8 9 10 11 12 13 14 15 . From all accounts, it is a rare complication, yet the adverse outcome from a duodenal perforation can be devastating.…”

Section: Introductionmentioning

confidence: 92%

A rare complication of ERCP: duodenal perforation due to biliary stent migration

et al. 2020

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Background and study aims Perforation of the duodenal wall opposing the major papilla due to a migrated pancreatobiliary stent rarely has been described in the literature as a complication of endoscopic retrograde cholangiopancreatography (ERCP). Factors associated with perforation from migrated stents from ERCP are unknown. Patients and methods This was a retrospective, observational study. Patients were identified from January 1, 1994 to May 31, 2019 in a prospectively maintained ERCP database. Results Eleven cases of duodenal perforation from migrated pancreatobiliary stents placed at ERCP were identified during the study period. All cases involved biliary stents, placed for biliary stricture management. The perforating stent was plastic in 10 cases (91 %). This complication occurred in one in 2,293 ERCP procedures in which a pancreatobiliary stent was placed. Conclusion This complication is more common with biliary stents compared to pancreatic stents. This may be related to the angle of exit of biliary stents being more perpendicular to the opposing duodenal wall and the near exclusive use of external pigtail plastic stents in the pancreatic duct. All perforating plastic stents were ≥ 9 cm in length. Longer stents may provide leverage for perforation with a migration event.

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“…90,91 Duodenoscopy or colonoscopy can be used to remove these incarcerated stents. 91,92 Contrarily, proximal stent migration further into the pancreatic duct presents a more serious condition and can result in pancreatitis, pancreatic parenchymal damage, or splenic artery perforation. 93 Forceps, snares, baskets, and balloons are conventional endoscopic removal methods, and a large number of innovative methods have been developed, such as the "stent-in-stent" technique, "lasso-over-the-guidewire" technique, and endoscopic tapered sheath-assisted removal.…”

Section: Stent Dysfunctionmentioning

confidence: 99%

“…However, cases of intestinal wall damage caused by stents have been reported 90,91 . Duodenoscopy or colonoscopy can be used to remove these incarcerated stents 91,92 . Contrarily, proximal stent migration further into the pancreatic duct presents a more serious condition and can result in pancreatitis, pancreatic parenchymal damage, or splenic artery perforation 93 .…”

Section: Complications Of Endoscopic Stent Placementmentioning

confidence: 99%

Pancreatic duct stents

Yi¹,

Li²,

Hu³

2022

J of Digest Diseases

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Pancreatic duct stenting using endoscopy or surgery is widely used for the management of benign and malignant pancreatic diseases. Endoscopic pancreatic stents are mainly used to relieve pain caused by chronic pancreatitis and pancreas divisum, and to treat pancreatic duct disruption and stenotic pancreaticointestinal anastomosis after surgery. They are also used to prevent postendoscopic retrograde cholangiopancreatography pancreatitis and postoperative pancreatic fistula, treat pancreatic cancer, and locate radiolucent stones. Recent advances in endoscopic techniques, such as endoscopic ultrasonography and balloon enteroscopy, and newly designed stents have broadened the indications for pancreatic duct stenting. In this review we outlined the types, insertion procedures, efficacy, and complications of endoscopic pancreatic duct stent placement, and summarized the applications of pancreatic duct stents in surgery.

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Retroperitoneal Perforation Caused by Migration of a Pancreatic Spontaneous Dislodgement Stent into Periampullary Diverticula

Cited by 10 publications

References 12 publications

A Rare Complication of ERCP: Duodenal Perforation Due to Biliary Stent Migration

A Rare Complication of ERCP: Duodenal Perforation Due to Biliary Stent Migration

A rare complication of ERCP: duodenal perforation due to biliary stent migration

Pancreatic duct stents

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