Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Kafrelsheikh University, Kafr El-Shaikh.
Tropical Medicine Department, faculty of Medicine, Zagazig University, Zagazig, Egypt.
Eur J Gastroenterol Hepatol. 2021 Jul 1;33(7):967-973. doi: 10.1097/MEG.0000000000002078.
The frequency, risk factors as well as the sites of biliary stent migration are variable in the literature. This retrospective study investigated the frequency of biliary stent migration, why biliary stents migrated, how the migrated stents affected the patients, and what are the different techniques retrieved the migrated stents.
Out of 876 stented patients, 74 patients (8.4%) had their stents migrated. Patients with and without migrated stents were compared regarding endoscopy and stent-related parameters. The sequels of stent migrations were reported. Furthermore, the methods used for stent retrieval were reviewed.
Proximal and distal stent migration occurred at a rate of 3 and 5.5%, respectively. The independent predictors for stent migration were moderate to marked common bile duct (CBD) dilation, complete sphincterotomy, the use of balloon dilation, and stent insertion for more than 1 month. Cholangitis and stent obstruction was the most commonly reported adverse event (n = 18, 24.3%). Distal stent migration associated with two cases of bleeding due to duodenal wall injury, and two cases of duodenal perforation. All the retained migrated stents in the current study were retrieved by endoscopy using extraction balloon, Dormia basket, snares, and foreign body forceps.
Biliary stent migration occurs at a rate of 8.4%. Stents do migrate because of dilated CBD, wide sphincterotomy, and biliary balloon dilation. Furthermore, wide, straight stents inserted for more than 1 month easily migrate. The migrated stents migrated intraluminal in the CBD, duodenum or the colon. All the retained migrated stents were retrieved endoscopically.
文献中胆管支架迁移的频率、危险因素以及部位各不相同。本回顾性研究调查了胆管支架迁移的频率、支架为何迁移、迁移的支架如何影响患者以及取回迁移支架的不同技术。
在 876 例支架置入患者中，74 例（8.4%）支架发生迁移。比较了有和无支架迁移的患者在内镜和支架相关参数方面的差异。报告了支架迁移的后果。此外，还回顾了取回支架的方法。
近端和远端支架迁移的发生率分别为 3%和 5.5%。支架迁移的独立预测因素为中至重度胆总管扩张、完全括约肌切开术、球囊扩张、支架置入超过 1 个月。胆管炎和支架阻塞是最常见的不良事件（n = 18，24.3%）。远端支架迁移与两例因十二指肠壁损伤引起的出血和两例十二指肠穿孔有关。本研究中所有残留的迁移支架均通过内镜使用取石球囊、Dormia 篮、圈套器和异物钳取出。
胆管支架迁移的发生率为 8.4%。支架迁移是由于 CBD 扩张、广泛的括约肌切开术和胆道球囊扩张引起的。此外，宽而直的支架置入超过 1 个月容易迁移。迁移的支架在 CBD、十二指肠或结肠内迁移。所有残留的迁移支架均通过内镜成功取出。
