Abstract
We experienced 2 cases of chronic pancreatitis with proximal migration of an endoscopic pancreatic stent (EPS). Case 1 was a 52-year-old woman who had idiopathic pancreatitis and had undergone EPS placement for stenosis of the main pancreatic duct. Case 2 was a 45-year-old man who had alcoholic pancreatitis and had undergone EPS placement for stenosis of the main pancreatic duct and pancreatic stones. In both cases, EPS exchange was performed for acute exacerbation of the pancreatitis with stent occlusion. However, the EPS migrated into the main pancreatic duct at the time of stent removal in case 1 and during replacement in case 2. We initially used a rat-tooth forceps, balloon catheter, and basket catheter for retrieving the migrated EPSs. However, stent retrieval was unsuccessful. Subsequently, using wire-guided biopsy forceps, we could grasp the distal end of the migrated EPS and successfully retrieve it. Endoscopic pancreatic stenting is a minimally invasive and effective option for painful chronic pancreatitis with stenosis of the main pancreatic duct, but complications, including stent migration, may occur during this procedure. Our cases suggested that wire-guided biopsy forceps can be used to pass through the narrow segment of the main pancreatic duct to grasp the distal end of the EPS and that the axes of the forceps and EPS can be set using a guide wire. Therefore, we concluded that wire-guided biopsy forceps should be useful for grasping and retrieving stents with proximal migration.
