Management of Proximal Migrated Biliary Stents: Single Center Experience

Abstract

Background and Aims: Migration in biliary stents is one of the expected complications of biliary stenting. Since proximally migrated biliary stents may result in serious complications, management of proximally migrated biliary stents are important. In this study we aimed to evaluate our patients with proximally migrated biliary stents and review current medical literature. Materials and Methods: Patients with proximally migrated biliary stents who had endoscopic retrograde cholangiopancreatography application at Health Sciences University, Adana City Training and Research Hospital, Department of Gastroenterology between September 2017- November 2022 were included in the study. Patients’ files and electronic database of our hospital were screened and evaluated retrospectively. Patients’ clinic and laboratory data were recorded. Results: The study included 57 patients. Mean age was 60.7 ± 14.5 (29-90) and 30 (52.6%) were male. Thirty four patients were asymptomatic other remaining patients presented with abdominal pain, jaundice, or fever. Fifteen (26.3%) patients had cholangitis and five patients had liver abscess during presentation. One patient died due to cholangitis associated with proximally migrated biliary stents. In 31 patients, proximally migrated biliary stents were removed successfully in our hospital. After stent removal, two patients had post-endoscopic retrograde cholangiopancreatography complications (post-endoscopic retrograde cholangiopancreatography pancreatitis and bleeding). Four patients had surgical intervention. In nine patients, stents were removed in external centers. In 13 patients, proximally migrated biliary stents could not be extracted. Conclusions: Proximal migration of biliary stents is an important complication of biliary stenting. Patients may be asymptomatic or symptomatic. Proximally migrated biliary stents may result in serious complications such as cholangitis, liver abscess and even death. Thus, early diagnosis and proper treatment are important in these patients. Proximally migrated biliary stents may be removed in most patients with endoscopic retrograde cholangiopancreatography.