Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 21, 2009; 15(19): 2423-2424
Published online May 21, 2009. doi: 10.3748/wjg.15.2423
Biliary drainage of the common bile duct with an enteral metal stent
Irene M Dek, Bram DJ van den Elzen, Paul Fockens, Erik AJ Rauws
Irene M Dek, Bram DJ van den Elzen, Paul Fockens, Erik AJ Rauws, Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
Author contributions: Dek IM was the primary author; Rauws EAJ performed the investigations; Dek IM, van den Elzen BDJ and Rauws EAJ wrote the paper; Fockens P was secondary supervisor and expert advisor.
Correspondence to: Dr. Bram DJ van den Elzen, PhD, MD, Department of Gastroenterology & Hepatology Academic Medical Centre Amsterdam, Room C2-220, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. b.d.vandenelzen@amc.nl
Telephone: +31-20-5669111
Fax: +31-20-6917033
Received: February 6, 2009
Revised: April 16, 2009
Accepted: April 23, 2009
Published online: May 21, 2009
Abstract

In this case report we present an elderly patient who was referred to our hospital with recurrent episodes of cholangitis that persisted after placement of five metal stents for a distal common bile duct (CBD) stenosis. All metal stents were endoscopically removed from the CBD by forceps after balloon dilatation of the papilla. A profoundly dilated CBD with sludge and concrements was seen. To ensure adequate bile drainage an enteral metal stent was inserted in the CBD. This case shows that proximally migrated uncovered metal stents in the CBD can be safely removed endoscopically under certain circumstances. We suggest that in the case of a CBD drainage problem due to an extremely dilated CBD, placement of an enteral metal stent in the CBD could be considered, especially in patients who are unfit for surgery.

Keywords: Cholangitis; Dilated common bile duct; Endoscopic retrograde cholangiopancreatography; Enteral metal stent; Metal stent removal