Kajitani Satoshi, Matsumoto Kazuyuki, Oki Kentaro, Matsumi Akihiro, Miyamoto Kazuya, Fujii Yuki, Uchida Daisuke, Tsutsumi Koichiro, Horiguchi Shigeru, Otsuka Motoyuki
Department of Gastroenterology and Hepatology Okayama University Hospital Okayama Japan.
DEN Open. 2025 Mar 11;5(1):e70096. doi: 10.1002/deo2.70096. eCollection 2025 Apr.
A 64-year-old woman had undergone subtotal stomach-preserving pancreaticoduodenectomy for locally advanced pancreatic head cancer. She had an uneventful postoperative course with no recurrence. However, approximately 18 months after surgery, she presented with recurrent abdominal pain. Although contrast-enhanced computed tomography abdominal radiographs showed internal stent migration to the residual pancreas, dilatation of the tail side of the pancreatic duct was observed. The impaired internal stent was considered to be the cause of the abdominal pain. An attempt to remove the stent via balloon-assisted endoscopy was unsuccessful as the pancreaticojejunostomy site could not be reached. Consequently, endoscopic ultrasonography-guided pancreatic duct drainage was performed, and a plastic stent was placed through the jejunal site to the stomach. Two months later, the endosonographically/endoscopic ultrasonography-guided created route was dilated, and an endoscopic introducer was inserted into the pancreatic duct. Biopsy forceps were advanced through the sheath, allowing the successful removal of the stent by direct grasping. The symptoms of the patient improved, and she was discharged without complications.
一名64岁女性因局部晚期胰头癌接受了保留胃的胰十二指肠次全切除术。术后恢复顺利，无复发。然而，术后约18个月，她出现了复发性腹痛。尽管腹部增强计算机断层扫描显示内部支架迁移至残余胰腺，但观察到胰管尾侧扩张。受损的内部支架被认为是腹痛的原因。试图通过球囊辅助内镜取出支架未成功，因为无法到达胰空肠吻合部位。因此，进行了内镜超声引导下的胰管引流，并通过空肠部位向胃内放置了一个塑料支架。两个月后，在内镜超声引导下扩张了所建立的通道，并将内镜导入器插入胰管。活检钳通过鞘管推进，通过直接抓取成功取出了支架。患者症状改善，无并发症出院。
