Stent migration necessitating surgical intervention

Surg Endosc. 2003 Nov;17(11):1803-7. doi: 10.1007/s00464-002-9163-5. Epub 2003 Sep 29.

Abstract

Background: Internal drainage with transhepatically or endoscopically placed endoprostheses has been used for many years as a temporary or definitive treatment for biliary tract obstruction. As a late complication, stent migration may occur.

Methods: We reviewed our records to identify patients who were operated on for a migrated endoprosthesis that was causing complications. In all, five such patients were identified.

Results: One patient had a large bowel perforation. Bowel penetration led to an interenteric fistula in one patient and to a biliocolic fistula formation in another. Small bowel distension was found in two patients. Surgical treatment consisted of local excision in three patients, segmental resection in one patient, and a bypass operation in the patient with biliocolic fistula. Postoperatively, four patients recovered without problems, but one patient died during a complicated postoperative course.

Conclusion: If a stent becomes stuck in the gastrointestinal tract and is not accessible for endoscopic removal, early operative revision is mandatory to prevent further complications.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Surgical
  • Biliary Fistula / etiology
  • Biliary Fistula / surgery
  • Cholangiopancreatography, Endoscopic Retrograde
  • Cholestasis / surgery
  • Colon*
  • Colon, Sigmoid
  • Colonoscopy
  • Fatal Outcome
  • Female
  • Foreign-Body Migration / etiology
  • Foreign-Body Migration / surgery*
  • Humans
  • Intestinal Fistula / etiology
  • Intestinal Fistula / surgery
  • Intestinal Perforation / etiology
  • Intestinal Perforation / surgery
  • Jejunum*
  • Liver Transplantation
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / surgery
  • Pancreatic Pseudocyst / surgery
  • Pancreatitis / surgery
  • Postoperative Complications / surgery
  • Retrospective Studies
  • Stents / adverse effects*