Early Duodenal Perforation After Biliary Stent Placement. A Case Report and Literature Review
Okoli, Fidelis, M.D.1; Golfeyz, Shmuel, M.D.2; Hamshow, Mohammad, M.D., MRCS, FACS3; Mayer, Ira, M.D., FACP, FACG, AGAF2, NYSGEF; Iswara, Kadirawel, M.D., FACP, FACG, AGAF2
1Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, New York University Langone Hospital, Long Island, New York
2Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maimonides Medical Center, Brooklyn, New York
3Department of Surgery, Division of Hepatobiliary Surgery, Maimonides Medical Center, Brooklyn, New York
*Corresponding Author: Okoli, Fidelis, M.D, Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, New York University Langone Hospital, Long Island, New York.
January 12, 2022; Published: February 16, 2022
Endoscopic retrograde cholangiopancreatography (ERCP) with biliary stent placement is a common procedure performed to reestablish bile flow for conditions in which there is obstruction of the common bile, hepatic and pancreatic ducts. Stent migration is a common occurrence and many measures, such as creation of internal flanges and pigtails, have been taken to mitigate this from happening. Stent migration with intestinal perforation is a rare but well recognized life-threatening late complication. Herein, we report a case of a biliary stent causing a duodenal perforation that was diagnosed laparoscopically four days after stent placement. Additionally, we will review the literature on presentation, diagnosis and management of intestinal perforation from biliary stent placement.
Keywords: Endoscopic Retrograde Cholangiopancreatography; Biliary Stent; Intestinal Perforation; Abdominal Pain; Primary Sclerosing Cholangitis
- Lammer J and Neumayer K. “Biliary drainage endoprostheses: experience with 201 placements”. Radiology 3 (1986): 625-629.
- Mueller PR., et al. “Biliary stent endoprosthesis: analysis of complications in 113 patients”. Radiology 3 (1985): 637-639.
- Johanson JF., et al. “Incidence and risk factors for biliary and pancreatic stent migration”. Gastrointestinal Endoscopy 3 (1992): 341-346.
- Chaurasia OP., et al. “Endoscopic techniques for retrieval of proximally migrated biliary stents: the Amsterdam experience”. Gastrointestinal Endoscopy 6 (1990): 780-785.
- Arhan M., et al. “Migration of biliary plastic stents: experience of a tertiary center”. Surgical Endoscopy 4 (2009): 769-775.
- Yaprak M., et al. “Biliary stent migration with duodenal perforation”. The Eurasian Journal of Medicine3 (2008): 154-156.
- Namdar T., et al. “Complications and treatment of migrated biliary endoprostheses: a review of the literature. World Journal of Gastroenterology 40 (2007): 5397-5399.
- Soehendra N and Reynders-Frederix V. “Palliative bile duct drainage - a new endoscopic method of introducing a transpapillary drain”. Endoscopy 1 (1980): 8-11.
- Belyaev O., et al. “Double sigmoid colon perforation by a migrated biliary stent”. Acta Chirurgica Belgica 1 (2008): 125-126.
- Issa H., et al. “Migration of a biliary stent causing duodenal perforation and biliary peritonitis”. World Journal of Gastrointestinal Endoscopy 10 (2013): 523-526.
- Rasalkar DD., et al. “Migrating biliary stent with final destination at the ileocecal junction causing intestinal obstruction and obstructive biliopathy”. The Indian Journal of Radiology and Imaging4 (2010): 304-306.
- Diller R., et al. “Stent migration necessitating surgical intervention”. Surgical Endoscopy 11 (2003): 1803-1807.
- Miller G., et al. “Retroperitoneal perforation of the duodenum from biliary stent erosion”. Current Surgery 5 (2005): 512-515.
- Saranga Bharathi R., et al. “Iatrogenic duodenal perforations caused by endoscopic biliary stenting and stent migration: an update”. Endoscopy 12 (2006): 1271-1274.
- Barut I and Tarhan OR. “Cecum perforation due to biliary stent migration”. Saudi Medical Journal 7 (2014): 747-749.
- Akimboye F., et al. “Migration of endoscopic biliary stent and small bowel perforation within an incisional hernia”. Surgical Laparoscopy, Endoscopy and Percutaneous Techniques 1 (2006): 39-40.
- Mastorakos DP., et al. “An unusual complication of a biliary stent-small bowel perforation of an incarcerated hernia sac”. The American Journal of Gastroenterology 12 (1998): 2533-2535.
- Storkson RH., et al. “Gut perforation caused by biliary endoprosthesis”. Endoscopy 1 (2000): 87-89.
- Roses LL., et al. “Clip closure of a duodenal perforation secondary to a biliary stent”. Gastrointestinal Endoscopy 4-1 (2000): 487-489.