Laparoscopic distal pancreatectomy for retrieval of a proximally migrated pancreatic stent

Pancreatic stents placed by ERCP are common in the treatment of benign and malignant pancreatic and biliary disease. Proximal migration of the stent into the duct occurs in 2% to 5% of cases, often resulting in pancreatitis. Although technically challenging, proximally migrated pancreatic stents can...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the Society of Laparoendoscopic Surgeons 2012-01, Vol.16 (1), p.169-172
Main Authors: Lucas, Donald J, Glaser, Jacob J, Pearl, Jonathan P
Format: Article
Language:English
Subjects:
Adult
Biliary Dyskinesia - surgery
Case Reports
Cholangiopancreatography, Endoscopic Retrograde
Female
Foreign-Body Migration - diagnostic imaging
Foreign-Body Migration - surgery
Humans
Laparoscopy - methods
Magnetic Resonance Angiography
Pancreas - diagnostic imaging
Pancreatectomy - methods
Pancreatic Ducts
Retreatment
Sphincter of Oddi Dysfunction - surgery
Sphincterotomy, Endoscopic
Stents - adverse effects
Tomography, X-Ray Computed
Ultrasonography
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Pancreatic stents placed by ERCP are common in the treatment of benign and malignant pancreatic and biliary disease. Proximal migration of the stent into the duct occurs in 2% to 5% of cases, often resulting in pancreatitis. Although technically challenging, proximally migrated pancreatic stents can usually be removed endoscopically. Little has been written about surgical management of irretrievable stents, and no reports of laparoscopic approaches were found. We report on a case of unsuccessful ERCP retrieval of a proximally migrated pancreatic stent. Using laparoscopy, we exposed the pancreas and used ultrasound to locate the distal end of the stent. We incised the pancreas at that point, removed the stent, and completed the distal pancreatectomy with splenectomy. Several case series on retrieval of migrated pancreatic stents are reviewed. Although ERCP is often successful and sometimes requires several attempts, we recommend surgical consultation after the first or second failed ERCP.
ISSN:1086-8089
1938-3797
DOI:10.4293/108680812X13291597716708