Nhân một trường hợp lấy stent tụy lạc chỗ thành công

Introduction: A proximally pancreatic duct stent migration is a severe complication after a pancreatic stent placement if not retrieved. The endoscopic retrieval of these stents is still challenging, and several cases require surgical intervention. We present a successful endoscopic stent migration retrieval case with main pancreatic duct (PD) fibrosis and stricture due to chronic pancreatitis and PD stone. Case presentation: A 36-year-old female patient was admitted to the hospital due to recurrent pancreatitis. Five months prior, she had undergone a 5 Fr × 7 cm plastic pancreatic stent placement due to PD stones. One month after the stent placement, the patient experienced several episodes of recurrence of acute pancreatitis. A computed tomography (CT) scan revealed that the stent had migrated to the tail of the pancreas, angled 90 degrees to the head of the pancreas, with stenosis in front of the stent due to PD stones and fibrosis. ERCP was performed with a balloon 6 mm in size dilation and Domina basket to grasp vertically the proximal end of the stent, which was manipulated near the Teflon tube to avoid injury to the pancreatic duct. The stent was then pulled out safely. The patient was discharged after several days at the hospital. Conclusion: Pancreatic stent migration is a complication after stent placement and can be dangerous for the patient if not removed. Currently, there is no consensus on removing PD migrated stents combining both groups C and D. In this case, the key to success was the use of a basket with a guidewire, dilation of the pancreatic duct with a large balloon, pushing the stent out of pancreatic branch duct and vertical stent removal with high safety.