BALLOON TRAWL; A SAFE AND EFFECTVE WAY OF REMOVING COMMON BILE DUCT (CBD) EMBEDDED STENTS

  • Shafqat Mehmood Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore
  • Faisal Zeb Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore

Abstract

Biliary stenting has been used since the 1970s to relieve biliary obstruction for a variety of causes including benign and malignant biliary strictures. Migration of stents proximally into the biliary tree or distally into the intestinal tract is relatively uncommon. We report a case of a 64-year-old female with a peri-ampullary tumour, who had symptomatic obstructive jaundice following endoscopic retrograde cholangiopancreatography and plastic stent insertion. Follow-up imaging showed proximal migration of the plastic stent and blockage of the distal common bile duct (CBD) secondary to the periampullary tumour. The biliary stent was safely removed endoscopically using balloon trawl. This case highlights that, while biliary stenting for strictures is generally safe and effective, stent migration to proximal CBD can occur. Balloon trawl is safe and effective way of removing such stents.

Key words: Biliary stricture, common bile duct, endoscopic retrograde cholangiopancreatography, periampullary tumour, stents 

Author Biography

Faisal Zeb, Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore
Consultant Gastroenterologist

References

Lammer J, Neumayer K. Biliary drainage endoprostheses: Experience with 201 placements. Radiology 1986;159: 625-62.

Tarnasky PR, Cotton PB, Baillie J, et al. Proximal migration of biliary stents: Attempted endoscopic retrieval in forty-one patients. Gastrointest Endosc 1995;42:513-20.

Arhan M, Odemiş B, Parlak E, et al. Migration of biliary plastic stents: Experience of a tertiary center. Surg Endosc 2009;23: 769 75.

Sakai Y, Tsuyuguchi T, Ishihara T, et al. Cholangiopancreatography troubleshooting: The usefulness of endoscopic retrieval of migrated biliary and pancreatic stents. Hepatobiliary Pancreat Dis Int 2009;8:632-7.

Lahoti S, Catalano MF, Geenen JE, et al. Endoscopic retrieval of proximally migrated biliary and pancreatic stents: Experience of a large referral center. Gastrointest Endosc 1998;47:486-91.

Chaurasia OP, Rauws EA, Fockens P, et al. Endoscopic techniques for retrieval of proximally migrated biliary stents: The Amsterdam experience. Gastrointest Endosc 1999;50: 780-5.

Panagiotis K, Jannis K, George P, et al. Migration of plastic biliary stents and endoscopic retrieval: An experience of three referral centers. Surg Laparosc Endosc Percutan Tech 2009;19:217-21

Published
2015-04-30
How to Cite
1.
Mehmood S, Zeb F. BALLOON TRAWL; A SAFE AND EFFECTVE WAY OF REMOVING COMMON BILE DUCT (CBD) EMBEDDED STENTS. J Cancer Allied Spec [Internet]. 2015Apr.30 [cited 2024Mar.28];1(1). Available from: https://journals.sfu.ca/jcas/index.php/jcas/article/view/9