Proximal migration of biliary prosthesis. Endoscopic extraction techniques
Alfredo, G.; Raúl, A.; Barinagarrementeria, R.; Gutiérrez-Bermúdez, J.A.; Martínez-Burciaga, J.
Revista de Gastroenterologia de Mexico 66(1): 22-26
2001
ISSN/ISBN: 0375-0906 PMID: 11464625 Document Number: 528419
Proximal migration of a biliary stent is an uncommon event, but its management can present a technical challenge to the therapeutic endoscopist. We reviewed the methods that have been used for retrieval of proximally migrated biliary stents in a referral endoscopic center. PATIENTS-METHOD, AND RESULTS: From January 1995 to December 1998, there were 410 procedures for insertion of biliary stents. Eighteen patients had migrated biliary stents; 15 stents (83%) were extracted successfully. One half of the stents were retrieved by grasping the stent directly with a wire basket. Four were recovered using the Soehendra device, and a stone retrieval balloon alongside the stents to provide traction indirectly in two patients. Surgical techniques were necessary in three cases. In patients with a dilated duct, indirect traction with a balloon or direct grasping of the stent with a wire basket is usually successful. Cannulating the stent lumen with a wire is often the best approach in patients with biliary stricture or nondilated duct. Using these techniques, most proximally migrated biliary stents can be retrieved endoscopically.