A case in which the tip of a plastic stent placed to prevent recurrence of walled‐off necrosis penetrated the bile duct and formed a stent–stone complex
Abstract A woman in her 60s underwent endoscopic sphincterotomy for choledocholithiasis. Unfortunately, post‐endoscopic retrograde cholangiopancreatography pancreatitis occurred. In addition, huge walled‐off necrosis (WON) appeared as a late complication. For the infected WON, endoscopic ultrasound‐...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-04-01
|
| Series: | DEN Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/deo2.220 |
| _version_ | 1797837217868021760 |
|---|---|
| author | Fumi Sakuma Atsushi Irisawa Satoaki Noguchi Yoko Abe Koki Hoshi Akira Yamamiya Kazunori Nagashima Ken Kashima Yasuhito Kunogi Koh Fukushi Kohei Inaba Ken Oike Saori Furuki Keiichi Tominaga Kenichi Goda |
| author_facet | Fumi Sakuma Atsushi Irisawa Satoaki Noguchi Yoko Abe Koki Hoshi Akira Yamamiya Kazunori Nagashima Ken Kashima Yasuhito Kunogi Koh Fukushi Kohei Inaba Ken Oike Saori Furuki Keiichi Tominaga Kenichi Goda |
| author_sort | Fumi Sakuma |
| collection | DOAJ |
| description | Abstract A woman in her 60s underwent endoscopic sphincterotomy for choledocholithiasis. Unfortunately, post‐endoscopic retrograde cholangiopancreatography pancreatitis occurred. In addition, huge walled‐off necrosis (WON) appeared as a late complication. For the infected WON, endoscopic ultrasound‐guided fistuloplasty and endoscopic necrosectomy were performed, and a double pigtail plastic stent (PS) (7Fr, 7 cm) was placed to prevent a recurrence. Plain computed tomography conducted two years later showed that the stent implanted for WON had deviated. The distal end of the stent was found to have migrated into the bile duct. In addition, common bile duct stones with stents as nuclei were observed. Upon performing endoscopic retrograde cholangiography, it was revealed that the stent tip perforated the distal bile duct just above the papilla. After removal of the stent using grasping forceps, we made an incision between the duodenal – bile duct fistula and bile duct orifice using a sphincterotome. Then, the stone was removed by a balloon catheter. Although such late adverse events are rare occurrences, placement of long‐term PS after treatment of WON should be followed up regularly with imaging examination, and if there is no recurrence for several months, removal of the PS at that point may be considered. |
| first_indexed | 2024-04-09T15:22:17Z |
| format | Article |
| id | doaj.art-2e25020f3193444fbdfb658782f2fac8 |
| institution | Directory Open Access Journal |
| issn | 2692-4609 |
| language | English |
| last_indexed | 2024-04-09T15:22:17Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | DEN Open |
| spelling | doaj.art-2e25020f3193444fbdfb658782f2fac82023-04-29T05:12:57ZengWileyDEN Open2692-46092023-04-0131n/an/a10.1002/deo2.220A case in which the tip of a plastic stent placed to prevent recurrence of walled‐off necrosis penetrated the bile duct and formed a stent–stone complexFumi Sakuma0Atsushi Irisawa1Satoaki Noguchi2Yoko Abe3Koki Hoshi4Akira Yamamiya5Kazunori Nagashima6Ken Kashima7Yasuhito Kunogi8Koh Fukushi9Kohei Inaba10Ken Oike11Saori Furuki12Keiichi Tominaga13Kenichi Goda14Department of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanDepartment of Gastroenterology Dokkyo Medical University Tochigi JapanAbstract A woman in her 60s underwent endoscopic sphincterotomy for choledocholithiasis. Unfortunately, post‐endoscopic retrograde cholangiopancreatography pancreatitis occurred. In addition, huge walled‐off necrosis (WON) appeared as a late complication. For the infected WON, endoscopic ultrasound‐guided fistuloplasty and endoscopic necrosectomy were performed, and a double pigtail plastic stent (PS) (7Fr, 7 cm) was placed to prevent a recurrence. Plain computed tomography conducted two years later showed that the stent implanted for WON had deviated. The distal end of the stent was found to have migrated into the bile duct. In addition, common bile duct stones with stents as nuclei were observed. Upon performing endoscopic retrograde cholangiography, it was revealed that the stent tip perforated the distal bile duct just above the papilla. After removal of the stent using grasping forceps, we made an incision between the duodenal – bile duct fistula and bile duct orifice using a sphincterotome. Then, the stone was removed by a balloon catheter. Although such late adverse events are rare occurrences, placement of long‐term PS after treatment of WON should be followed up regularly with imaging examination, and if there is no recurrence for several months, removal of the PS at that point may be considered.https://doi.org/10.1002/deo2.220adverse eventsbile ductfistulastent stone complexwalled‐off necrosis |
| spellingShingle | Fumi Sakuma Atsushi Irisawa Satoaki Noguchi Yoko Abe Koki Hoshi Akira Yamamiya Kazunori Nagashima Ken Kashima Yasuhito Kunogi Koh Fukushi Kohei Inaba Ken Oike Saori Furuki Keiichi Tominaga Kenichi Goda A case in which the tip of a plastic stent placed to prevent recurrence of walled‐off necrosis penetrated the bile duct and formed a stent–stone complex DEN Open adverse events bile duct fistula stent stone complex walled‐off necrosis |
| title | A case in which the tip of a plastic stent placed to prevent recurrence of walled‐off necrosis penetrated the bile duct and formed a stent–stone complex |
| title_full | A case in which the tip of a plastic stent placed to prevent recurrence of walled‐off necrosis penetrated the bile duct and formed a stent–stone complex |
| title_fullStr | A case in which the tip of a plastic stent placed to prevent recurrence of walled‐off necrosis penetrated the bile duct and formed a stent–stone complex |
| title_full_unstemmed | A case in which the tip of a plastic stent placed to prevent recurrence of walled‐off necrosis penetrated the bile duct and formed a stent–stone complex |
| title_short | A case in which the tip of a plastic stent placed to prevent recurrence of walled‐off necrosis penetrated the bile duct and formed a stent–stone complex |
| title_sort | case in which the tip of a plastic stent placed to prevent recurrence of walled off necrosis penetrated the bile duct and formed a stent stone complex |
| topic | adverse events bile duct fistula stent stone complex walled‐off necrosis |
| url | https://doi.org/10.1002/deo2.220 |
| work_keys_str_mv | AT fumisakuma acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT atsushiirisawa acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT satoakinoguchi acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT yokoabe acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT kokihoshi acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT akirayamamiya acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT kazunorinagashima acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT kenkashima acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT yasuhitokunogi acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT kohfukushi acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT koheiinaba acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT kenoike acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT saorifuruki acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT keiichitominaga acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT kenichigoda acaseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT fumisakuma caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT atsushiirisawa caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT satoakinoguchi caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT yokoabe caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT kokihoshi caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT akirayamamiya caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT kazunorinagashima caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT kenkashima caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT yasuhitokunogi caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT kohfukushi caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT koheiinaba caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT kenoike caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT saorifuruki caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT keiichitominaga caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex AT kenichigoda caseinwhichthetipofaplasticstentplacedtopreventrecurrenceofwalledoffnecrosispenetratedthebileductandformedastentstonecomplex |