Case Report
Copyright ©The Author(s) 2024.
World J Gastrointest Endosc. Jul 16, 2024; 16(7): 432-438
Published online Jul 16, 2024. doi: 10.4253/wjge.v16.i7.432
Table 1 Published case reports of endoscopic retrograde cholangiopancreatography-related stent malpositioning in the portal vein
Ref.
Gender, age
Indication for ERCP
Procedure
Stent
Clinical manifestation
Treatment
Follow-up
Outcome
Stableforth et al[6], 2011Male, 73Pancreatic cancerPBS replacement7-Fr, 10-cm straightConsistent jaundice; Brisk bleeding after removal of the stent; Filling of the portal vein and rapid washout of contrast material; confirmed by CTPBS left in situ; metal stent placement via PTC2 monthsNo complications
Miloudi et al[7], 2011Female, 60Benign narrowing of the CBD after transplantationPBS replacement10-Fr, 10-cmDifficult insertion of the new PBS; Fever and abdominal pain shortly after ERCP; Confirmed by abdominal ultrasound and CTSurgery to remove the prosthesis, close the fistula, repair the portal vein, and develop hepatico-jejunal anastomosisSeveral daysUneventful
Leung et al[8], 2012Female, 10Recurrent pancreatitisPancreatic sphincterotomy, pancreatic stent placement3-Fr, 6 cm, pigtailFever, abdominal pain, and elevated amylase; Confirmed by ultrasound and CTRemove the stent by ERCP on the 3rd postoperative day3 monthsPortal vein thrombosis gradually resolved
Dawwas et al[9], 2013Male, 69CBD stonesDifficult cannulation, biliary sphincterotomy, PBS placement7-Fr, 4-cm, double pigtailBleeding after removal of previous stent, and faint, rapidly dissipating, biliary-like opacification on contrast injectionsAbandon the procedure immediately2 monthsGas and thrombosis in the portal vein gradually resolved
So et al[10], 2015Male, 55Hilar invasion of hepatocellular carcinomaPBS replacementNARecurrent melena and bacteremia; Exacerbated bleeding after removing the stent; Cholangiography revealed leakage of contrast dye into the portal veinPlacing fully covered self-expandable metal stent in the bile ductSeveral daysRecovering from recurrent bacteremia and bleeding
Russo et al[11], 2017Female, 39Acute cholangitisBiliary sphincterotomy, failed sweeping of stones by a ballon, and PBS placement7-Fr, 7-cmResistance on stent placement, bleeding upon stent deploymentPBS left in situ, emergent laparotomy to repair the injury and T-tube placementSeveral daysResolve from the surgery
João et al[12], 2022Female, 60Biliary anastomotic stenosis after liver transplantationDifficult cannulation, biliary sphincterotomy, balloon dilation, PBS placementTwo 8.5-Fr, 9.0-cmSpurting hemorrhage when removing the stentEndoscopic removal of stent, percutaneous transhepatic fully covered self-expanded metal stent in the portal vein1 monthClinically stable, no bleeding relapse
Lin et al[3], 2023Male, 34CBD stones, cholangitisDifficult cannulation, sphincterotomy, balloon dilation, PBS placement7-FrHemobilia upon inserting the stent; Confirmed by CT scanSurgery: Cholecystectomy and CBD stones
removement, endoscopic removal of stent
9 monthsUneventful
Taşar et al[4], 2023Female, 54CBD stones, cholangitisDifficult cannulation, sphincterotomy, stone extraction, PBS placement10-Fr, 7-cmHemorrhage, fever and persistent jaundice; Confirmed by CT scanLaparoscopic exploration with ERCPSeveral monthsChronic portal thrombus