Pancreatic stent migration into the main pancreatic duct during endoscopic papillary balloon dilation

Abstract We report the first case of pancreatic stent (PS) migration placed early into the main pancreatic duct (MPD) during endoscopic retrograde cholangiopancreatography (ERCP) due to subsequent endoscopic papillary balloon dilation. A 74‐year‐old woman who complained of fever and abdominal pain w...

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Main Authors: Toji Murabayashi, Mayu Kawabata, Shinya Sugimoto
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:DEN Open
Subjects:
Online Access:https://doi.org/10.1002/deo2.363
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author Toji Murabayashi
Mayu Kawabata
Shinya Sugimoto
author_facet Toji Murabayashi
Mayu Kawabata
Shinya Sugimoto
author_sort Toji Murabayashi
collection DOAJ
description Abstract We report the first case of pancreatic stent (PS) migration placed early into the main pancreatic duct (MPD) during endoscopic retrograde cholangiopancreatography (ERCP) due to subsequent endoscopic papillary balloon dilation. A 74‐year‐old woman who complained of fever and abdominal pain was diagnosed with acute calculous cholangitis. On ERCP, a needle‐knife precut papillotomy was performed from the orifice because of difficult cannulation. Because of unintentional guidewire insertion into the MPD from the orifice, a PS with bilateral flaps was promptly placed to prevent post‐ERCP pancreatitis. After successful biliary cannulation from the orifice alongside the PS, endoscopic papillary balloon dialtion was performed, leading to PS migration into the MPD during the dilation. Two days after the first ERCP, the migrated PS was successfully removed on the second ERCP. The strategy of early PS placement in the ERCP session appears theoretically promising for preventing post‐ERCP pancreatitis. However, early PS placement during the ERCP session should be noted to pose the risk of migration into the MPD, especially when pushing the device into the bile duct.
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spelling doaj-art-cb9382e8f4e547e3a8b8580dd41aa0152025-08-20T03:38:54ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.363Pancreatic stent migration into the main pancreatic duct during endoscopic papillary balloon dilationToji Murabayashi0Mayu Kawabata1Shinya Sugimoto2Department of Gastroenterology Ise Red Cross Hospital Mie JapanDepartment of Gastroenterology Ise Red Cross Hospital Mie JapanDepartment of Gastroenterology Ise Red Cross Hospital Mie JapanAbstract We report the first case of pancreatic stent (PS) migration placed early into the main pancreatic duct (MPD) during endoscopic retrograde cholangiopancreatography (ERCP) due to subsequent endoscopic papillary balloon dilation. A 74‐year‐old woman who complained of fever and abdominal pain was diagnosed with acute calculous cholangitis. On ERCP, a needle‐knife precut papillotomy was performed from the orifice because of difficult cannulation. Because of unintentional guidewire insertion into the MPD from the orifice, a PS with bilateral flaps was promptly placed to prevent post‐ERCP pancreatitis. After successful biliary cannulation from the orifice alongside the PS, endoscopic papillary balloon dialtion was performed, leading to PS migration into the MPD during the dilation. Two days after the first ERCP, the migrated PS was successfully removed on the second ERCP. The strategy of early PS placement in the ERCP session appears theoretically promising for preventing post‐ERCP pancreatitis. However, early PS placement during the ERCP session should be noted to pose the risk of migration into the MPD, especially when pushing the device into the bile duct.https://doi.org/10.1002/deo2.363EPBDERCPmigrateMPDremoval
spellingShingle Toji Murabayashi
Mayu Kawabata
Shinya Sugimoto
Pancreatic stent migration into the main pancreatic duct during endoscopic papillary balloon dilation
DEN Open
EPBD
ERCP
migrate
MPD
removal
title Pancreatic stent migration into the main pancreatic duct during endoscopic papillary balloon dilation
title_full Pancreatic stent migration into the main pancreatic duct during endoscopic papillary balloon dilation
title_fullStr Pancreatic stent migration into the main pancreatic duct during endoscopic papillary balloon dilation
title_full_unstemmed Pancreatic stent migration into the main pancreatic duct during endoscopic papillary balloon dilation
title_short Pancreatic stent migration into the main pancreatic duct during endoscopic papillary balloon dilation
title_sort pancreatic stent migration into the main pancreatic duct during endoscopic papillary balloon dilation
topic EPBD
ERCP
migrate
MPD
removal
url https://doi.org/10.1002/deo2.363
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AT mayukawabata pancreaticstentmigrationintothemainpancreaticductduringendoscopicpapillaryballoondilation
AT shinyasugimoto pancreaticstentmigrationintothemainpancreaticductduringendoscopicpapillaryballoondilation