Successful Percutaneous Transhepatic Removal of an Internal Plastic Stent Migrated into the Intrahepatic Bile Duct after Pancreatoduodenectomy

Abstract

Two patients suffered from repeated cholangitis. Follow-up computed tomography showed dilatation of the intrahepatic bile ducts due to internal plastic stents that had migrated into the intrahepatic bile ducts after choledochojejunostomy. Endoscopic approaches were initially attempted in both cases; however, they failed because of complete migration of the internal plastic stents into the hepatic ducts. Both patients were successfully treated with percutaneous transhepatic removal of the internal plastic stents and balloon cholangioplasty in a single session, without any complications. After the procedure, the patients remained well, without any evidence of cholangitis or dilatation of bile ducts.

Removal of internal plastic stents is crucial in the management of patients with morbidity caused by residual stents, and this interventional procedure should be recognized as a treatment option in such challenging cases.