TY - JOUR
T1 - Surgical relief of small bowel obstruction by migrated biliary stent
T2 - Extraction without enterotomy
AU - Garg, Karan
AU - Zagzag, Jonathan
AU - Khaykis, Inessa
AU - Liang, Howard
PY - 2011/4
Y1 - 2011/4
N2 - Background: Distal stent migration is a well-known complication following insertion of biliary stents. Most such cases can be managed expectantly, because the stents pass through the gastrointestinal tract. However, small bowel obstruction as a result of the stent mandates surgical intervention. Methods: We report the case of a patient who had distal stent migration causing a small bowel obstruction. We successfully retrieved the stent without an enterotomy, by using a combination of laparoscopy, endoscopy, and fluoroscopy. Our unique technique greatly decreased the risk of bacterial peritonitis in this patient with decompensated cirrhosis and associated ascites, which in this patient population results in a high mortality. Results: Management of small bowel obstruction secondary to biliary stent migration necessitates operative intervention. Retrieval of a dislodged stent can be performed safely without subjecting the patient to an enterotomy or a small bowel resection. Postoperative morbidity should be significantly reduced by this approach. Conclusion: Retrieval of biliary stents in cases of small bowel obstruction without perforation may be successfully performed without enterotomy or bowel resection. A similar approach may be applied to other foreign bodies dislodged in the small bowel.
AB - Background: Distal stent migration is a well-known complication following insertion of biliary stents. Most such cases can be managed expectantly, because the stents pass through the gastrointestinal tract. However, small bowel obstruction as a result of the stent mandates surgical intervention. Methods: We report the case of a patient who had distal stent migration causing a small bowel obstruction. We successfully retrieved the stent without an enterotomy, by using a combination of laparoscopy, endoscopy, and fluoroscopy. Our unique technique greatly decreased the risk of bacterial peritonitis in this patient with decompensated cirrhosis and associated ascites, which in this patient population results in a high mortality. Results: Management of small bowel obstruction secondary to biliary stent migration necessitates operative intervention. Retrieval of a dislodged stent can be performed safely without subjecting the patient to an enterotomy or a small bowel resection. Postoperative morbidity should be significantly reduced by this approach. Conclusion: Retrieval of biliary stents in cases of small bowel obstruction without perforation may be successfully performed without enterotomy or bowel resection. A similar approach may be applied to other foreign bodies dislodged in the small bowel.
KW - Biliary stent migration
KW - Surgical management of small bowel obstruction from biliary stent migration
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U2 - 10.4293/108680811X13071180406998
DO - 10.4293/108680811X13071180406998
M3 - Article
C2 - 21902982
AN - SCOPUS:80052437375
SN - 1086-8089
VL - 15
SP - 232
EP - 235
JO - Journal of the Society of Laparoendoscopic Surgeons
JF - Journal of the Society of Laparoendoscopic Surgeons
IS - 2
ER -