Korean J Gastrointest Endosc.  2011 Mar;42(3):195-200.

A Case of Argon Plasma Trimming of a Biliary Metallic Stent Causing a Duodenal Obstruction

Affiliations
  • 1Department of Internal Medicine, Kyunghee University College of Medicine, Seoul, Korea. gidrdong@chol.com

Abstract

Metallic stents are being widely used in patients with a malignant obstruction of the biliary tract. The advent of metallic stents was heralded as a solution to the problem of plastic stent occlusion. Metallic stents prolong stent patency by lowering occlusion rates, but they may malfunction for several reasons, including occlusion from tumor ingrowth or migration after the procedure. Distal migration or impaction of metallic stents against the duodenal wall may cause severe complications, including duodenal obstruction, perforation and acute upper gastrointestinal bleeding. Several techniques have been developed to manage distal migration of a biliary metallic stent and remove the malfunctioning stent endoscopically. We report on a 43-year-old male who underwent endoscopic palliative biliary drainage because of obstructive pancreatic head cancer. We transected the distal end of the metallic stent using an argon plasma coagulator, treating the duodenal obstruction without any complications.

Keyword

Argon plasma coagulation; Metallic stent; Trimming

MeSH Terms

Adult
Argon
Argon Plasma Coagulation
Biliary Tract
Drainage
Duodenal Obstruction
Head and Neck Neoplasms
Hemorrhage
Humans
Male
Plasma
Plastics
Stents
Argon
Plastics
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