Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Hepatobiliary Pancreat Dis Int. 2009 Dec;8(6):632-7.
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.
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.
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.
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.
支架迁移到肝胆管可能是胆管或胰腺支架相关的罕见并发症之一。虽然有一些取回迁移支架的程序，包括手术、经皮和内镜方法，但应首先尝试内镜，因为它的侵入性最小。本研究旨在评估内镜取回迁移的胆管和胰腺支架的有用性。
使用内镜逆行胰胆管造影术取回迁移到胆管（35 例）或胰管（2 例）的塑料支架。使用的器械包括圈套器、篮状导管、抓钳、活检钳、球囊导管和 Soehendra 支架回收器。
37 例患者中有 36 例（97.0%）成功进行了内镜取回迁移支架。用于成功治疗的器械包括篮状导管（13 例）、抓钳（10 例）、圈套器（8 例）、球囊导管（3 例）、活检钳（1 例）和 Soehendra 支架回收器（1 例）。1 例患有慢性胰腺炎的患者由于胆管狭窄导致导丝无法前进，且十二指肠也狭窄，治疗不成功而行手术。1 例患者在撤回支架后出现轻度胰腺炎，经保守治疗后胰腺炎缓解。
内镜取回迁移的胆管和胰腺支架似乎是有用的，因为它的安全性和低侵入性。然而，应该为取回迁移的支架准备各种钳子。
