Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2017; 9(10): 535-539
Published online Oct 16, 2017. doi: 10.4253/wjge.v9.i10.535
Endoscopic ultrasound-guided pancreaticogastrostomy for symptomatic pancreatic duct obstruction caused by migrated pancreatic stent
Lei Lu, Hang-Bin Jin, Jian-Feng Yang, Xiao-Feng Zhang
Lei Lu, Hang-Bin Jin, Jian-Feng Yang, Xiao-Feng Zhang, Department of Gastroenterology, Hangzhou First People’s Hospital, Nanjing Medical University, Hangzhou 310000, Zhejiang Province, China
Author contributions: All authors contributed to the acquisition of data, writing, and revision of this manuscript.
Institutional review board statement: This case report was reviewed and approved by the Hangzhou First People’s Hospital Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Xiao-Feng Zhang, Department of Gastroenterology, Hangzhou First People’s Hospital, Nanjing Medical University, Hangzhou 310000, Zhejiang Province, China. zxf837@tom.com
Telephone: +86-571-56006788
Received: March 24, 2017
Peer-review started: March 29, 2017
First decision: May 8, 2017
Revised: May 28, 2017
Accepted: June 30, 2017
Article in press: July 3, 2017
Published online: October 16, 2017
Abstract

Endoscopic pancreatic stenting has been widely used in various pancreatic conditions. With the increasing use of pancreatic stents, many complications have been recognized. Especially, proximal stent migration presents a serious condition because of subsequent pancreatic duct obstruction, impaired drainage, ductal dilation, and pancreatic pain. Although endoscopic retrieval is the preferred treatment for proximally migrated pancreatic stents, it is not always successful, resulting in conversion to surgery. To date, endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) has never been reported for treatment of pancreatic duct obstruction caused by proximally migrated pancreatic stent. We herein describe a case of pancreatic duct rupture and obstruction caused by proximally migrated pancreatic stent that was successfully treated by EUS-guided pancreaticogastrostomy while keeping the former stent in situ after failed endoscopic retrograde cholangiopancreatography. We believe that this report adds to the increasing evidence of symptomatic pancreatic duct obstruction being successfully treated by EUS-PD.

Keywords: Endoscopic retrograde cholangiopancreatography, Pancreatic stent, Stent migration, Pancreatic duct obstruction, Endoscopic ultrasound-guided pancreatic duct drainage

Core tip: Stent migration is a rare complication of pancreatic stenting. Especially, proximal migration presents a serious condition because of subsequent pancreatic duct obstruction, impaired drainage, and pancreatic pain. We described a case of symptomatic pancreatic duct obstruction caused by proximally migrated pancreatic stent that was successfully treated by endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) while keeping the former stent in situ. To the best of our knowledge, EUS-PD has never been reported for relief of pancreatic duct obstruction caused by proximally migrated pancreatic stent, and this report adds to the increasing evidence of the safety and effectiveness of EUS-PD.