2025 Volume 67 Issue 9 Pages 1450-1456
An eighty-six-year-old man was hospitalized with obstructive jaundice and cholangitis. An uncovered self-expandable metallic stent (USEMS) was placed to treat bile duct stenosis due to ampulla of Vater carcinoma.
Three days after USEMS placement, the patient developed severe nausea and vomiting. As no specific findings were noted on blood tests, abdominal imaging, or gastrointestinal endoscopy, we concluded that his symptoms were caused by the placement of the USEMS; thus, the decision was made to remove it.
We placed a fully covered self-expandable metallic stent (CSEMS) inside the USEMS using the stent-in-stent technique. Two weeks later, we attempted to remove both SEMSs but were unsuccessful.
Therefore, we performed large balloon dilation of the SEMSs and were able to safely remove both stents. Following stent removal, the patientʼs symptoms completely resolved.
Although we initially failed to remove the SEMSs using the stent-in-stent technique alone, successful removal was ultimately achieved by combining large-balloon dilatation with the stent-in-stent technique.
We conclude that this combined approach is a useful method for endoscopic removal of biliary USEMS.
