Successful redrainage after failure of lumen-apposing metal stents by addressing flange-induced ostial occlusion: A case report

Figure 5 Management of branch cavity ostium occlusion by lumen-apposing metal stents edge with plastic stents placement. A: Endoscopic view showing sealed lumen-apposing metal stents cavity-side opening; B: Lumen-apposing metal stents removal using a snare; C: Small fistula with purulent discharge at the 9 o’clock position of the cavity wall; D: Fluoroscopic confirmation of guidewires access into recurrent collection (arrow indicates guidewires); E: Fluoroscopic view showing nasobiliary drainage tube and double-pigtail stent placement (arrows indicate devices); F: Follow-up computed tomography demonstrating proper stents position and near-complete resolution of the collection.