Endoscopic Removal of an Embedded Biliary Wallstent by Piecemeal Extraction

Expandable metal biliary stents are reserved for patients with unresectable malignant biliary obstruction. Occasionally, these stents may cause complications necessitating removal. We describe successful endoscopic removal of a biliary Wallstent one year after insertion in a patient who initially underwent placement of an expandable metal biliary stent for presumed biliary malignancy. The stent was removed after a stent related bleeding duodenal ulcer formed.

References

• 1 Knyrim K, Wagner H J, Pausch J, Vabil N. A prospective randomized controlled trial of metal stents for malignant obstruction of the common bile duct.  Endoscopy. 1993;  35 207-212
• 2 Davids P HP, Groen A K, Rauws E AJ, et al. Randomized trial of self-expanding metal stents versus polyethylene stents for distal malignant biliary obstruction.  Lancet. 1992;  340 1488-1492
• 3 Dumonceau J M, Deviere J, Delhaye M, et al. Plastic and metal stents for post-operative benign bile duct strictures: the best and the worst.  Gastrointest Endosc. 1998;  47 8-17
• 4 Roebuck D J, Stanley P, Katz M D, et al. Gastrointestinal hemorrhage due to duodenal erosion by a biliary wallstent.  Cardiovasc Intervent Radiol. 1998;  21 63-65
• 5 Ahmed A, Keeffe E B, Imperial J C. A novel technique for endoscopic removal of expandable biliary Wallstent.  Gastrointest endosc. 1999;  50 279-282
• 6 Bethge N, Sommer A, Gross U, et al. Human tissue responses to metal stents implanted in vivo for the palliation of malignant stenoses.  Gastrointest Endosc. 1996;  43 596-602
• 7 Baron T H, Blacjard W G, Morgan D E. Endoscopic removal of a “floating” biliary Gianturco Z stent five years after placement for a benign anastomotic stricture in a liver transplant patient.  Gastrointest Endosc. 1997;  46 80-82