Surgical relief of small bowel obstruction by migrated biliary stent: Extraction without enterotomy

Karan Garg, Jonathan Zagzag, Inessa Khaykis, Howard Liang

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: Distal stent migration is a well-known complication following insertion of biliary stents. Most such cases can be managed expectantly, because the stents pass through the gastrointestinal tract. However, small bowel obstruction as a result of the stent mandates surgical intervention. Methods: We report the case of a patient who had distal stent migration causing a small bowel obstruction. We successfully retrieved the stent without an enterotomy, by using a combination of laparoscopy, endoscopy, and fluoroscopy. Our unique technique greatly decreased the risk of bacterial peritonitis in this patient with decompensated cirrhosis and associated ascites, which in this patient population results in a high mortality. Results: Management of small bowel obstruction secondary to biliary stent migration necessitates operative intervention. Retrieval of a dislodged stent can be performed safely without subjecting the patient to an enterotomy or a small bowel resection. Postoperative morbidity should be significantly reduced by this approach. Conclusion: Retrieval of biliary stents in cases of small bowel obstruction without perforation may be successfully performed without enterotomy or bowel resection. A similar approach may be applied to other foreign bodies dislodged in the small bowel.

Original languageEnglish (US)
Pages (from-to)232-235
Number of pages4
JournalJournal of the Society of Laparoendoscopic Surgeons
Volume15
Issue number2
DOIs
StatePublished - Apr 1 2011
Externally publishedYes

Keywords

  • Biliary stent migration
  • Surgical management of small bowel obstruction from biliary stent migration

ASJC Scopus subject areas

  • Surgery

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