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KMID : 0359020110420030195
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Korean Journal of Gastrointestinal Endoscopy
2011 Volume.42 No. 3 p.195 ~ p.200
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A Case of Argon Plasma Trimming of a Biliary Metallic Stent Causing a Duodenal Obstruction
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Cho Jun-Hyung
Dong Seok-Ho
Cho Chang-Hyun
Jang Jae-Young
Kim Hyo-Jong
Kim Byung-Ho
Chang Young-Woon
Chang Rin
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Abstract
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Metallic stents are being widely used in patients with a malignant obstruction of the biliary tract. The advent of metallic stents was heralded as a solution to the problem of plastic stent occlusion. Metallic stents prolong stent patency by lowering occlusion rates, but they may malfunction for several reasons, including occlusion from tumor ingrowth or migration after the procedure. Distal migration or impaction of metallic stents against the duodenal wall may cause severe complications, including duodenal obstruction, perforation and acute upper gastrointestinal bleeding. Several techniques have been developed to manage distal migration of a biliary metallic stent and remove the malfunctioning stent endoscopically. We report on a 43-year-old male who underwent endoscopic palliative biliary drainage because of obstructive pancreatic head cancer. We transected the distal end of the metallic stent using an argon plasma coagulator, treating the duodenal obstruction without any complications.
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KEYWORD
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Argon plasma coagulation, Metallic stent, Trimming
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