Takahashi Koji, Ohyama Hiroshi, Mikata Rintaro, Nagashima Hiroki, Ohno Izumi, Takiguchi Yuichi, Kato Naoya
Department of Gastroenterology, Graduate School of Medicine, Chiba University, Japan.
Department of Medical Oncology, Graduate School of Medicine, Chiba University, Japan.
J Rural Med. 2022 Jul;17(3):189-192. doi: 10.2185/jrm.2022-003. Epub 2022 Jul 1.
Retrieval is challenging once prophylactic pancreatic stents migrate deep into the pancreatic duct. Herein, we describe a case of successful endoscopic retrieval of a migrated prophylactic pancreatic stent using a basket catheter through a biliary plastic stent pusher tube. A 71 year-old man was referred to our hospital for removal of a straight-shaped migrated 5-Fr 3-cm prophylactic pancreatic stent with a flap on the duodenal side. There were no subjective symptoms at the time of the hospital visit. During endoscopic retrograde cholangiopancreatography, we inserted an 8.5-Fr plastic biliary stent pusher tube in front of the migrated pancreatic stent. The stent was then grasped using a basket catheter for peroral cholangioscopy through the biliary stent pusher tube. The stent was pulled into the pusher tube and was successfully retrieved from the pancreatic duct. No complications were associated with endoscopic retrograde cholangiopancreatography. Although rare, prophylactic pancreatic duct stent migration after pancreatic duct guidewire placement should be noted. In our case, endoscopic retrieval of a migrated prophylactic pancreatic stent using a basket catheter for peroral cholangioscopy through the biliary plastic stent pusher tube was successful.
一旦预防性胰腺支架深入胰腺导管内迁移，取出就具有挑战性。在此，我们描述了一例通过篮状导管经胆道塑料支架推送管成功内镜取出迁移的预防性胰腺支架的病例。一名71岁男性因取出十二指肠侧带有瓣膜的直形5Fr、3cm迁移性预防性胰腺支架而被转诊至我院。就诊时无主观症状。在内镜逆行胰胆管造影术中，我们在迁移的胰腺支架前方插入了一根8.5Fr的塑料胆道支架推送管。然后通过胆道支架推送管使用用于经口胆管镜检查的篮状导管抓住支架。将支架拉入推送管并成功从胰腺导管中取出。内镜逆行胰胆管造影术未出现并发症。尽管罕见，但应注意胰腺导管导丝置入后预防性胰腺导管支架迁移的情况。在我们的病例中，通过篮状导管经胆道塑料支架推送管进行经口胆管镜检查成功内镜取出迁移的预防性胰腺支架。
