Gut Liver.  2011 Dec;5(4):532-535.

Wire-Guided Endoscopic Snare Retrieval of Proximally Migrated Pancreatic Stents after Endoscopic Papillectomy for Ampullary Adenoma

Affiliations
  • 1Digestive Disease Center, Department of Internal Medicine, Soon Chun Hyang University School of Medicine, Bucheon and Seoul, Korea. jhmoon@schmc.ac.kr
  • 2Department of Internal Medicine, Eulji University College of Medicine, Daejeon, Korea.
  • 3Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

Abstract

With the increasing use of pancreatic duct (PD) stents after endoscopic papillectomy (EP), complications such as proximal migration of the stent have become increasingly prevalent. A PD stent that migrates within a nondilated PD may be difficult to remove endoscopically. We performed endoscopic retrieval of proximally migrated PD stents after EP in 5 patients. Endoscopic retrieval was performed immediately after EP in one patient, the next day in 3 patients, and 2 weeks later in one patient. Wire-guided endoscopic retrieval was attempted in 4 patients, and the migrated stents were removed successfully in these 4 patients. No significant procedure-related complications occurred, other than mild pancreatitis in a single patient. In one patient, endoscopic retrieval performed immediately after EP failed when using the conventional method, and the migrated stent was removed using a minisnare without a guidewire the next day; this patient developed severe pancreatitis. Wire-guided endoscopic snare retrieval seems to be a safe and effective method for removing proximally migrated PD stents after EP.

Keyword

Endoscopic papillectomy; Migrated pancreatic stent; Endoscopic retrieval

MeSH Terms

Adenoma
Humans
Pancreatic Ducts
Pancreatitis
SNARE Proteins
Stents
SNARE Proteins
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