Acute Pancreatitis Caused by Impaction of Migrated Surgical Staples in the Duodenal Papilla After Distal Pancreatectomy

ABSTRACT A 67‐year‐old woman underwent a laparoscopic distal pancreatectomy for pancreatic body cancer. On postoperative day (POD) 23, the patient presented with epigastric pain and was diagnosed with delayed peripancreatic fluid collection, which was treated with antibiotics and percutaneous drainage. On POD 51, the patient developed recurrent epigastric pain. Laboratory tests revealed elevated pancreatic enzyme and inflammatory marker levels. Computed tomography revealed acute pancreatitis and a high‐density area in the duodenal papilla suggestive of a foreign body. Endoscopic retrograde cholangiopancreatography revealed that the surgical staples were impacted in the minor duodenal papilla and were successfully removed. Although pancreatography did not demonstrate residual staples, three additional staples were subsequently removed from the pancreatic duct. Pancreatitis improved after endoscopic treatment, and the patient was discharged. This case suggests that the migration of staples used during surgery may be a contributing factor to postoperative pancreatitis.