Delayed removal of a deeply migrated pigtail pancreatic stent in a normal pancreatic duct

Background: Acute pancreatitis is a common complication of endoscopic retrograde cholangiopancreatography (ERCP). Several medical and surgical procedures have been analyzed in prevention of post-ERCP pancreatitis as a major post-ERCP complication, so we conducted a study to assess the role of prophylactic pancreatic stents on prevention and severity of post-ERCP pancreatitis. Materials and Methods: This case control studied adult patients undergoing ERCP at the ERCP unit of a referral educational hospital. Data of the case (stent, N=90) and control (non-stent) (N=105) groups were retrieved from medical records. In our center, sphinctrerotomy was performed for 103 patients of non-stent group and successful pancreatic stent placement was done in 86 patients of stent group in a standard fashion. In stent group, a 5F, 4 centimeter pancreatic stent was emplaced over a guide wire under fluoroscopic guidance. All post–ERCP pancreatitis and major complications of all patients were retrieved too. Results: Of 255 enrolled patients, 195 were at high risk of post-ERCP pancreatitis allocated in two groups of this study. Successful pancreatic stent placement was done in 86 patients (95.6%) of stent group. There was no major complication during procedures. The migration of pancreatic duct stent was diagnostic in 3 (3.5%) patients. The overall post ERCP pancreatitis was 4.0% and 16.6% in stent and non-stent groups, respectively. Conclusion: Based on our findings in this study, we strongly recommended pancreatic duct stent placement in high-risk patients; although the experience of endoscopist plays a crucial role. [GMJ.2015;4(2):67-71]

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TWO CASES OF DELAYED REMOVAL OF MIGRATED PANCREATIC STENT SOLVED WITH THE SAME TECHNIQUE – FOREIGN-BODY FORCEPS

10.1055/s-0039-1681873 ◽

2019 ◽

Author(s):

G Mendes Simões ◽

M Kumar Goenka

Keyword(s):

Foreign Body ◽

Pancreatic Stent ◽

Delayed Removal

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Roux-en-Y fistulojejunostomy as a salvage procedure for displaced pancreatic stent in disconnected pancreatic duct syndrome with refractory external pancreatic fistula

HPB ◽

10.1016/j.hpb.2020.11.555 ◽

2021 ◽

Vol 23 ◽

pp. S221

Author(s):

N. Shivathirthan ◽

S. Devapatla ◽

M. Joshi

Keyword(s):

Pancreatic Fistula ◽

Pancreatic Duct ◽

Salvage Procedure ◽

Pancreatic Stent ◽

Duct Syndrome

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Transpancreatic Precut Sphincterotomy for Biliary Access: The Relation of Sphincterotomy Size to Immediate Success Rate of Biliary Cannulation

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2014/864082 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Lien-Fu Lin

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Success Rate ◽

Pancreatic Duct ◽

Main Pancreatic Duct ◽

The Other ◽

Pancreatic Stent ◽

Biliary Cannulation ◽

Needle Knife ◽

Precut Sphincterotomy

Background. Transpancreatic precut sphincterotomy (TPS) is an option for difficult common bile duct (CBD) access, and the reports are few, with immediate success rate varying from 60 to 96%. The description of relation between the size of TPS and the immediate success rate of CBD cannulation was not found in the literature. The Aim of the Study. To evaluate the relation of large TPS to immediate success rate of CBD cannulation. Methods. A retrospective analysis was performed in prospectively collected data of 20 patients. TPS was performed with traction papillotome in the main pancreatic duct (MPD) directing towards 11 o’clock. Needle knife (NK) was used to enlarge TPS in five patients, and the other 15 cases had large TPS from the beginning of sphincterotomy. Prophylactic pancreatic stent was inserted in 18 cases, with diclofenac given in 12 cases. Results. The immediate success rate of CBD cannulation was 90% and with an eventual success rate of 100%. The failure in one immediate CBD cannulation with large TPS was due to atypical location of CBD orifice, and the other failed immediate CBD cannulation was due to inadequate size of TPS. Complications included 3 cases of post-TPS bleeding and 3 cases of mild pancreatitis. Conclusion. TPS is an effective procedure in patients with difficult biliary access and can have high immediate success rate with large TPS.

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Endoscopic Retrieval Technique of Proximally Migrated Pancreatic Stents: A Retrospective Study in a Tertiary Centre

Gastroenterology Research and Practice ◽

10.1155/2015/485980 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Yi Lu ◽

Zheng Jin ◽

Jia-chuan Wu ◽

Li-ke Bie ◽

Biao Gong

Keyword(s):

Retrospective Study ◽

Adverse Events ◽

Pancreatic Duct ◽

Clinical Information ◽

Stent Migration ◽

Point Of View ◽

Pancreatic Stent ◽

Success Rates ◽

Tertiary Centre ◽

Endoscopic Retrieval

Background. There were scarce trials concerning the treatments and outcomes of proximal pancreatic stent migration. Herein, we did a retrospective study to discuss this problem from an endoscopist’s point of view.Patients and Methods. From January 2009 to June 2014, patients with proximally migrated pancreatic duct stents were identified. Their clinical information was viewed. Retrieval techniques, success rates, and adverse events were analyzed.Results. A total of 36 procedures were performed in 34 patients; the median age of the patients was 53 years, with 17 males and 17 females. Eight patients’ pancreatic duct stents could still be seen in the major or minor papilla and were pulled out with a snare forceps or a grasping forceps; in the remaining 28 procedures, the management was somewhat thorny; the retrieval called for several devices. Final success was achieved in 31 patients. No adverse event was observed in the process of ERCP procedures, 5 patients developed post-ERCP pancreatitis (PEP), 1 patient got infection, and 1 patient had haemorrhage.Conclusions. Endoscopic retrieval of migrated pancreatic stent is safe and less invasive; nonetheless, attention should be paid so as to reduce the incidence and degree of related adverse events, especially PEP.

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