Successful removal of an internal pancreatic stent that migrated into the bile duct using double-balloon enteroscopy after pancreaticoduodenectomy
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Internal stents used during pancreaticoduodenectomy (PD) are generally spontaneously passed through the rectum by defecation. However, we encountered six patients with internal stents that migrated into the bile duct after PD. We herein report the outcomes of these six patients and the usefulness of double-balloon enteroscopy (DBE) for removal of such stents from the bile duct.
An internal stent was placed across pancreaticojejunostomy in 416 (68.8%) of 605 consecutive patients undergoing PD between 2005 and 2015. This study evaluated the characteristics and outcomes of the six patients whose internal stent migrated into the bile duct.
Migration of an internal stent into the bile duct was found during follow-up computed tomography (CT) in 6 (1.4%) of 416 patients who had an internal stent placed during PD. Three patients developed stent-induced cholangitis, and two had bile duct stones. Excluding one patient whose internal stent spontaneously slipped out and disappeared from the bile duct, all patients underwent successful removal of a stent from the bile duct by a single instance of biliary intervention involving DBE.
Removal of a stent from the bile duct using DBE is a feasible and useful procedure that should be considered if an internal stent is detected during follow-up CT after PD.
KeywordsInternal pancreatic stent Pancreaticoduodenectomy Migration Bile duct Double-balloon enteroscopy
HY and SH had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: SH, MK, MK, and HY. Acquisition or interpretation of data: SH, YY, KO, MM, and MU. Draft of the manuscript: SH, MK, YY, and HY. Critical revision of the manuscript for important intellectual content: SH, YY, MK, and HY. Administrative, technical, or material support: SH, MK, YY, YM, MI, and HY. Study supervision: MK and HY.
Compliance with ethical standards
Conflict of interest
We have no financial interests or potential conflicts of interest.
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