BACKGROUND:Stent migration in the hepatopancreatic duct might arise as one of the rare complications associated with biliary or pancreatic stenting.Although there are some procedures to retrieve the migrated stent,inc...BACKGROUND:Stent migration in the hepatopancreatic duct might arise as one of the rare complications associated with biliary or pancreatic stenting.Although there are some procedures to retrieve the migrated stent,including surgical,percutaneous,and endoscopic approaches,endoscopy should be attempted first because it is least invasive.This study set out to evaluate the usefulness of endoscopic retrieval of migrated biliary and pancreatic stents.METHODS:Plastic stents that migrated in the bile duct(35 patients)or pancreatic duct(2)were retrieved with endoscopic retrograde cholangiopancreatography.Devices used were snare forceps,a basket catheter,grasping forceps,biopsy forceps,a balloon catheter,and the Soehendra stent retriever.RESULTS:Endoscopic retrieval of migrated stents was performed successfully in 36(97.0%)of the 37 patients.The devices utilized for successful treatment were basket catheter(13 patients),grasping forceps(10),snare forceps(8),balloon catheter(3),biopsy forceps(1),and the Soehendra stent retriever(1).The unsuccessfully treated patient with chronic pancreatitis underwent surgery since the guide wire did not move forward due to bile duct stenosis,and there was also duodenal stenosis.One patient developed mild pancreatitis after withdrawal of the stent;the pancreatitis was relieved with conservative treatment.CONCLUSIONS:Endoscopic retrieval of migrated biliary and pancreatic stents appears to be useful because of its safety and low invasiveness.However,various forceps should be prepared for the retrieval of a migrated stent.展开更多
BACKGROUND:Proximal migration of pancreatic stent (PMPS)is an infrequent event but its management can be technically challenging and there are no standard retrieval methods.This study aimed to determine the results of...BACKGROUND:Proximal migration of pancreatic stent (PMPS)is an infrequent event but its management can be technically challenging and there are no standard retrieval methods.This study aimed to determine the results of an endoscopic stent retrieval algorithm in terms of feasibility and efficacy of the endoscopic procedure. METHODS:During the period from January 2008 to December 2009,15 patients(8 women and 7 men with a mean age of 51.9 years)with PMPS were included in this study.Stent retrieval was approached initially with balloon extraction followed by rat-tooth forceps and basket.A rescue approach such as using a stent retriever was attempted when other approaches failed. RESULTS:All the PMPSs(six 5Fr,nine 7Fr)were retrieved successfully within one ERCP session.Balloon extraction was successful in 9(60%)patients.In the 6 failed cases of balloon extraction,wire-guided rat-tooth forceps grasp was successful in 4,and stone extraction basket grasp was successful in 1 in whom forceps grasp failed.One stent was finally rescued with a stent retriever when balloon extraction,forceps and basket grasp all failed.In patients with successful balloon extraction,44.4% (4/9)developed post-ERCP hyperamylasemia but none of them developed post-procedure pancreatitis. CONCLUSIONS:With this algorithm,5Fr and 7Fr PMPS were successfully retrieved in all of the patients.Most PMPSs can be safely retrieved with the commonly-used approaches in this study.Those less used approaches can be used as a rescue method.展开更多
文摘BACKGROUND:Stent migration in the hepatopancreatic duct might arise as one of the rare complications associated with biliary or pancreatic stenting.Although there are some procedures to retrieve the migrated stent,including surgical,percutaneous,and endoscopic approaches,endoscopy should be attempted first because it is least invasive.This study set out to evaluate the usefulness of endoscopic retrieval of migrated biliary and pancreatic stents.METHODS:Plastic stents that migrated in the bile duct(35 patients)or pancreatic duct(2)were retrieved with endoscopic retrograde cholangiopancreatography.Devices used were snare forceps,a basket catheter,grasping forceps,biopsy forceps,a balloon catheter,and the Soehendra stent retriever.RESULTS:Endoscopic retrieval of migrated stents was performed successfully in 36(97.0%)of the 37 patients.The devices utilized for successful treatment were basket catheter(13 patients),grasping forceps(10),snare forceps(8),balloon catheter(3),biopsy forceps(1),and the Soehendra stent retriever(1).The unsuccessfully treated patient with chronic pancreatitis underwent surgery since the guide wire did not move forward due to bile duct stenosis,and there was also duodenal stenosis.One patient developed mild pancreatitis after withdrawal of the stent;the pancreatitis was relieved with conservative treatment.CONCLUSIONS:Endoscopic retrieval of migrated biliary and pancreatic stents appears to be useful because of its safety and low invasiveness.However,various forceps should be prepared for the retrieval of a migrated stent.
文摘BACKGROUND:Proximal migration of pancreatic stent (PMPS)is an infrequent event but its management can be technically challenging and there are no standard retrieval methods.This study aimed to determine the results of an endoscopic stent retrieval algorithm in terms of feasibility and efficacy of the endoscopic procedure. METHODS:During the period from January 2008 to December 2009,15 patients(8 women and 7 men with a mean age of 51.9 years)with PMPS were included in this study.Stent retrieval was approached initially with balloon extraction followed by rat-tooth forceps and basket.A rescue approach such as using a stent retriever was attempted when other approaches failed. RESULTS:All the PMPSs(six 5Fr,nine 7Fr)were retrieved successfully within one ERCP session.Balloon extraction was successful in 9(60%)patients.In the 6 failed cases of balloon extraction,wire-guided rat-tooth forceps grasp was successful in 4,and stone extraction basket grasp was successful in 1 in whom forceps grasp failed.One stent was finally rescued with a stent retriever when balloon extraction,forceps and basket grasp all failed.In patients with successful balloon extraction,44.4% (4/9)developed post-ERCP hyperamylasemia but none of them developed post-procedure pancreatitis. CONCLUSIONS:With this algorithm,5Fr and 7Fr PMPS were successfully retrieved in all of the patients.Most PMPSs can be safely retrieved with the commonly-used approaches in this study.Those less used approaches can be used as a rescue method.
