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World J Gastrointest Endosc. Mar 16, 2011; 3(3): 64-66
Published online Mar 16, 2011. doi: 10.4253/wjge.v3.i3.64
Published online Mar 16, 2011. doi: 10.4253/wjge.v3.i3.64
Stent-in-stent through a side hole to prevent biliary metallicstent migration
Wiriyaporn Ridtitid, Rungsun Rerknimitr, Surachai Amornsawadwattana, Yuwadee Ponauthai, Pinit Kullavanijaya, Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Author contributions: Ridtitid W and Rerknimitr R contributed equally to this work; Ridtitid W and Rerknimitr R developed the concept; Ridtitid W, Rerknimitr R; Amornsawadwattana S and Ponauthai Y contributed to acquisition of data; Rerknimitr R and Kullavanijaya P revised the paper for important intellectual content; and Ridtitid W and Rerknimitr R wrote the paper.
Correspondence to: Wiriyaporn Ridtitid, MD, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand. wiriyaporn_r@yahoo.com
Telephone: +66-2-2564265 Fax: +66-2-2527839
Received: November 1, 2010
Revised: December 17, 2010
Accepted: December 24, 2010
Published online: March 16, 2011
Revised: December 17, 2010
Accepted: December 24, 2010
Published online: March 16, 2011
Abstract
The covered self-expandable metallic stent (SEMS) has been developed to overcome the problem of tissue ingrowth, However, stent migration is a well-known complication of covered SEMS placement. Use of a double pigtail stent to lock the movement of the SEMS and prevent migration has been advised by many experts. Unfortunately, in our case this technique led to an incidental upward migration of the SEMS. We used APC to create a side hole in the SEMS for plastic stent insertion as stent-in-stent. This led to a successful prevention of stent migration.