Recognition and management of stent malposition in the portal vein during endoscopic retrograde cholangiopancreatography:A case report  

作　　者：Rui Wu Feng Zhang Hao Zhu Ming-Dong Liu Yu-Zheng Zhuge Lei Wang Bin Zhang 

机构地区：[1]Department of Gastroenterology,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu Province,China

出　　处：《World Journal of Gastrointestinal Endoscopy》2024年第7期432-438,共7页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND Portal vein injury is an uncommon complication of endoscopic retrograde cholangiopancreatography(ERCP),for which stent malpositioning in the portal vein is very rare and can lead to fatal events.We report a case of biliary stent migration to the portal vein and a novel method for its safe removal under the guidance of portal angiography.Moreover,we reviewed the literature and summarized reports on the identification and management of this condition.CASE SUMMARY A 59-year-old woman with pancreatic cancer presented with abdominal pain and a high fever 20 days after the placement of two plastic biliary stents under the guidance of ERCP.Blood cultures and laboratory tests revealed sepsis,which was treated with antibiotics.A contrast-enhanced computed tomography scan revealed that one of the biliary stents in the main portal vein was malpositioned.To safely remove the stent,portal angiography was performed to visualize the portal vein and to allow the management of any bleeding.The two stents were removed without obvious bleeding,and an uncovered self-expanding metal stent was placed in the common bile duct for drainage.The patient had an uneventful 6-month follow-up period,except for self-resolving portal vein thrombosis.CONCLUSION The combination of endoscopic and angiographic techniques allowed uneventful management of stent malposition in the portal vein.

关 键 词：Endoscopic retrograde cholangiopancreatography Stent malposition Portal vein Portal angiography Case report 

分 类 号：R656[医药卫生—外科学]