Rescue technique for endoscopic extraction of biliary stent with proximal migration: “zipline – forceps”
DOI:
https://doi.org/10.47892/rgp.2024.443.1726Keywords:
CPRE, Eventos adversos, stentAbstract
The endoscopic placement of a biliary stent presents adverse events, including proximal migration in the bile duct, a situation that can be so challenging to resolve that surgery must sometimes be resorted to. We present the case of a 83-year-old patient who underwent endoscopic retrograde cholangio pancreatography (ERCP) for acute cholangitis and a plastic biliary stent was placed for stenosis in the distal common bile duct. Four months later, proximal migration of the stent was evident; conventional extraction techniques were performed without success. Due to not having a cholangioscope, a novel method was designed in which a forceps is slid along a hydrophilic guide and guided to the distal portion of the stent in order to successfully trap and extract it. It is concluded that the “zipline” technique is an effective method that could be used safely in patients with proximal migration of a biliary stent in which its adherence to the biliary wall does not allow it to be linked with common methods, especially in situations where direct cholangioscopy is not available.
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Kawaguchi Y, Ogawa M, Kawashima Y, Mizukami H, Maruno A, Ito H, et al. Risk factors for proximal migration of biliary tube stents. World J Gastroenterol. 2014;20(5):1318-24. doi: 10.3748/wjg.v20.i5.1318.
Arhan M, Odemiş B, Parlak E, Ertuğrul I, Başar O. Migration of biliary plastic stents: experience of a tertiary center. Surg Endosc. 2009;23(4):769-775. doi: 10.1007/s00464-008-0067-x.
Dumonceau JM, Tringali A, Blero D, Devière J, Laugiers R, Heresbach D, et al. Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy. 2012;44(3):277-98. doi: 10.1055/s-0031-1291633.
Katsinelos P, Kountouras J, Paroutoglou G, Chatzimavroudis G, Paikos D, Zavos C, et al. Migration of plastic biliary stents and endoscopic retrieval: an experience of three referral centers. Surg Laparosc Endosc Percutan Tech. 2009;19(3):217-21. doi: 10.1097/SLE.0b013e3181a031f5.
Weaver MJ, Kushnir VM. Endoscopic retrieval of a proximally migrated biliary stent using extracorporeal shockwave lithotripsy, electrohydraulic lithotripsy, and cholangioscopy with minisnare. VideoGIE. 2021;6(5):231-233. doi: 10.1016/j.vgie.2021.01.005.
Al Lehibi A, Al Mtawa A, Almasoudi T, Al Ghamdi A, Al Otaibi N, Al Balkhi A. Removal of proximally migrated biliary stents by using single-operator cholangioscopy. VideoGIE. 2020;5(5):213-6. doi: 10.1016/j.vgie.2020.01.001.
Chatterjee A, Garg R, Simons-Linares R, Chahal P. Cognitive ERCP: decision making during successful retrieval of proximally migrated biliary stent. VideoGIE. 2022;8(2):73-74. doi: 10.1016/j.vgie.2022.09.007.
Calcara C, Broglia L, Comi G, Balzarini M. Plastic biliary Stent migration during multiple stents placement and successful endoscopic removal using intra-Stent balloon inflation technique: A case report and literature review. Am J Case Rep. 2016;17:65-9. doi: 10.12659/ajcr.896076.
Sobani ZA, Bham NS, Rustagi T. Proximal migration of a biliary stent: what to do after failure of conventional and cholangioscopic retrieval techniques. VideoGIE. 2021;6(4):170-1. doi: 10.1016/j.vgie.2020.12.007.
Hamada T, Takahara N, Nakai Y, Kanai S, Saito T, Koike K. The “zipline” technique for endoscopic transpapillary biliary biopsy. Endoscopy. 2020;52(03):236-7. doi: 10.1055/a-1015-6609.
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Copyright (c) 2024 Wilmer Gustavo Quiroga-Purizaca, Diego Ricardo Páucar-Aguilar, Emma Calderón-Yeren, Daniel Andrei Vargas-Blácido
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