A case of stent-stone complex around biliary plastic stent

Abstract

The patient was an 88-year-old male who had undergone EST and cholecystectomy for CBD and GB stones at the age of 84. He was admitted to our hospital with a diagnosis of cholangitis at the age of 87. CT and ERCP examination demonstrated a large stone in the CBD. Although we tried to remove the CBD stone endoscopically, it was impossible to eliminate the stone completely. He was discharged with biliary plastic stent (PS) in place. One year later, he was readmitted for the treatment of cholangitis. The PS was still in place, and multiple calculi were observed from the liver side to duodenal side of CBD by ERCP examination. It was impossible to remove the biliary PS endoscopically over three times. We had a policy of surgical removal of the PS because cholangitis was not improved. We changed the surgical procedure during the operation from choledochal lithotomy to transduodenal papilloplasty because of the intense adhesion around bile duct. A stent-stone complex was observed on the liver side of the removed biliary PS, making endoscopic stent removal difficult.