Clinical Endoscopy  2013;46(4):418-422

doi:10.5946/ce.2013.46.4.418

Endoscopic Removal of a Proximally Migrated Metal Stent during Balloon Sweeping after Stent Trimming.

Nam Jun CHO 1 ; Tae Hoon LEE ; Sang Heum PARK ; Han Min LEE ; Kyung Hee HYUN ; Suck Ho LEE ; Il Kwun CHUNG ; Sun Joo KIM

Affiliations

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Keywords

Pancreatic neoplasms; Stents; Cholangiopancreatography, endoscopic retrograde; Argon plasma coagulation

Country

Republic of Korea

Language

English

Abstract

Placement of a self-expanding metal stent (SEMS) is an effective method for palliation of a malignant biliary obstruction. However, metal stents can cause various complications, including stent migration. Distally migrated metal stents, particularly covered SEMS, can be removed successfully in most cases. Stent trimming using argon plasma coagulation may be helpful in difficult cases despite conventional methods. However, no serious complications related to the trimming or remnant stent removal method have been reported due to the limited number of cases. In particular, proximal migration of a remnant fragmented metal stent after stent trimming followed by balloon sweeping has not been reported. We report an unusual case of proximal migration of a remnant metal stent during balloon sweeping following stent trimming by argon plasma coagulation. The remnant metal stent was successfully removed with rotation technique using a basket and revised endoscopically.