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Medline ® Abstract for Reference 150

of 'Rare complications of endoscopic retrograde cholangiopancreatography (ERCP)'

Stent migration necessitating surgical intervention.
Diller R, Senninger N, Kautz G, Tübergen D
Surg Endosc. 2003;17(11):1803.
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 accessiblefor endoscopic removal, early operative revision is mandatory to prevent further complications.
Department of General Surgery, University Clinic of Muenster, Waldeyerstrasse 1, D-48149 Münster, Germany. diller@uni-muenster.de