A case of successful endoscopic removal of a stent-stone complex caused by a migrated biliary stent

Abstract

An 81-year-old woman had undergone endoscopic stenting as a therapy for acute cholangitis caused by choledocholithiasis. She was followed up with ursodeoxycholic acid (UDCA) treatment and stent placement for 2 years and 10 months. Thereafter, she was referred to our hospital because of the complete migration of the stent into the common bile duct. The migrated stent was successfully removed using forceps and basket. A bile duct stone was formed around the stent as the nidus which is called stent-stone complex (SSC). Stone component analysis showed that the SSC was composed of UDCA and bilirubin calcium. SSC is one of the complications related to long-term biliary stent placement. There are still few reports of SSC, although the number of reports may increase because patients with irretrievable common bile duct stones who are at a very high risk for surgical procedures or aggressive endoscopic management need long-term biliary stenting. Moreover, the stone component analysis indicated that long-term UDCA intake may induce calculus formation.