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      A Rare Complication of Biliary Stent Migration: Small Bowel Perforation in a Patient with Incisional Hernia

      case-report

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          Abstract

          Endoscopic biliary stents have been recently applied with increasing frequency as a palliative and curable method in several benign and malignant diseases. As a reminder, although most of the migrated stents pass through the intestinal tract without symptoms, a small portion can lead to complications. Herein, we present a case of intestinal perforation caused by a biliary stent in the hernia of a patient with a rarely encountered incarcerated incisional hernia.

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          Randomised trial of endoscopic stenting versus surgical bypass in malignant low bileduct obstruction.

          P Cotton, Harry Dowsett, Helen R. Russell … (1994)
          The development of non-surgical techniques for the relief of malignant low bileduct obstruction has cast doubt on the best way of relieving jaundice, particularly in patients fit for surgery whose life expectancy is more than a few weeks. We did a randomised prospective controlled trial comparing endoscopic stent insertion and surgical biliary bypass in patients with malignant low bileduct obstruction. 204 patients were randomised (surgery 103, stent 101); 3 subsequently proved to have benign disease and were excluded, leaving 101 surgical and 100 stented patients for assessment. Technical success was achieved in 94 surgical and 95 stented patients, with functional biliary decompression obtained in 92 patients in both groups. In stented patients, there was a lower procedure-related mortality (3% vs 14%, p = 0.01), major complication rate (11% vs 29%, p = 0.02), and median total hospital stay (20 vs 26 days, p = 0.001). Recurrent jaundice occurred in 36 stented patients and 2 surgical patients. Late gastric outlet obstruction occurred in 17% of stented patients and 7% of the surgical group. Despite the early benefits of stenting there was no significant difference in overall survival between the two groups (median survival: surgical 26 weeks; stented 21 weeks; p = 0.065). Endoscopic stenting and surgery are effective palliative treatments with the former having fewer early treatment-related complications and the latter fewer late complications.
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            Biliary stent endoprosthesis: analysis of complications in 113 patients.

            Elizabeth Butch, R. S. P. Mueller, S K Teplick … (1985)
            Stent endoprosthesis has been advocated as an alternative to internal-external catheter drainage for decompression of biliary obstruction, but drawbacks have never been specifically analyzed, to our knowledge. A retrospective review of 118 biliary stent endoprostheses placed in 113 patients assessed the frequency, nature, and treatability of significant complications. Complications were categorized as early (morbidity or mortality within the first 30 days) or late (after 30 days). The early complication rate was 17% (19/113); the late complication rate, 31% (32/102). Early complications were most often due to unstable stent positioning in technically difficult procedures involving periportal obstruction (4/8), while the most common late problems were lumen occlusion (23/102 [23%]), migrations (6/102 [6%]), and tumor overgrowth of the stent (3/102 [3%]). Neither the histologic features nor the location of the primary tumor correlated with the potential for long-term stent dysfunction. Specific treatment of complications was carried out in 17 of 102 patients (17%) and almost invariably required readmission and remanipulation or de novo biliary drainage.
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              Incidence and risk factors for biliary and pancreatic stent migration

              John Johanson, Michael Schmalz, Joseph Geenen (1992)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Case Rep Surg
                Journal ID (iso-abbrev): Case Rep Surg
                Journal ID (publisher-id): CRIS
                Title: Case Reports in Surgery
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-6900
                ISSN (Electronic): 2090-6919
                Publication date (Print): 2015
                Publication date (Electronic): 26 July 2015
                Volume: 2015
                Electronic Location Identifier: 860286
                Affiliations
                1Department of General Surgery, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey
                2Department of General Surgery, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
                3Department of General Surgery, Ceyhan Government Hospital, Adana, Turkey
                Author notes

                Academic Editor: Steve de Castro

                Article
                DOI: 10.1155/2015/860286
                PMC ID: 4529966
                SO-VID: da671e5b-6158-4836-a414-6c8115516b26
                Copyright © Copyright © 2015 Özkan Yilmaz et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 12 March 2015
                Date revision received : 8 July 2015
                Date accepted : 9 July 2015
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Surgery
                Data availability:
                ScienceOpen disciplines: Surgery

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