Randhawa Navkiran, Khalyfa Ahamed, Patel Raahi, Desai Rahil, Inamullah Mahnoor, Peng Haoran, Goduguchinta Varshita, Sridhar Subbaramiah, Ayub Kamran
Division of Gastroenterology and Hepatology, Augusta University, Augusta, GA 30912, USA.
Department of Gastroenterology, University of Iowa, Iowa City, IA 52242, USA.
J Clin Med. 2025 Jun 17;14(12):4298. doi: 10.3390/jcm14124298.
Pancreatic stents (PSs) play a crucial role in the management of pancreatic duct obstructions, particularly in the context of endoscopic retrograde cholangiopancreatography (ERCP). However, stent migration remains a significant complication, leading to risks such as pancreatitis, pancreatic duct stenosis, and abscess formation. This study aims to evaluate the efficacy of various endoscopic techniques for retrieving proximally migrated or broken pancreatic stents, highlighting optimal strategies for improving patient outcomes. A retrospective multicenter review was conducted across six hospitals from 2016 to 2024. Patients with proximally migrated or broken pancreatic stents referred for endoscopic retrieval after failed attempts at other facilities were included. Demographic data, stent characteristics, and retrieval techniques were analyzed. Endoscopic methods included SpyGlass forceps, SpyGlass baskets, Soehendra retriever stents, balloon sweeps, flower baskets, and extension pancreatic sphincterotomy. Procedural success, retrieval times, and post-procedural outcomes were assessed. Twelve patients underwent endoscopic retrieval, including two with broken stents. All procedures were successful, with retrieval times averaging 30 to 45 min. Two patients developed pancreatic duct narrowing, requiring balloon dilation. All patients had new stents placed to maintain duct patency, and no major complications were observed. Follow-up evaluations confirmed complete resolution of migration-related issues, with all stents removed. Endoscopic retrieval of migrated pancreatic stents is highly effective, with specialized techniques ensuring a 100% success rate in this study. Early intervention and the selection of appropriate retrieval methods are critical in minimizing complications. Further research is needed to refine retrieval strategies and standardize protocols to enhance clinical outcomes.
胰管支架（PSs）在胰管梗阻的治疗中起着关键作用，尤其是在内镜逆行胰胆管造影术（ERCP）的背景下。然而，支架移位仍然是一个重大并发症，会导致胰腺炎、胰管狭窄和脓肿形成等风险。本研究旨在评估各种内镜技术用于取出近端移位或断裂的胰管支架的疗效，强调改善患者预后的最佳策略。对2016年至2024年期间六家医院进行了一项回顾性多中心研究。纳入了在其他机构尝试失败后转诊进行内镜取出的近端移位或断裂胰管支架的患者。分析了人口统计学数据、支架特征和取出技术。内镜方法包括SpyGlass活检钳、SpyGlass网篮、Soehendra取出支架、球囊清扫、花篮和延长胰括约肌切开术。评估了手术成功率、取出时间和术后结果。12例患者接受了内镜取出，其中2例为支架断裂。所有手术均成功，取出时间平均为30至45分钟。2例患者出现胰管狭窄，需要球囊扩张。所有患者均放置了新的支架以维持导管通畅，未观察到重大并发症。随访评估证实与移位相关的问题完全解决，所有支架均已取出。内镜取出移位的胰管支架非常有效，在本研究中，专门技术确保了100%的成功率。早期干预和选择合适的取出方法对于减少并发症至关重要。需要进一步研究以完善取出策略并规范方案，以提高临床结果。
