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A Case of Argon Plasma Trimming of a Biliary Metallic Stent Causing a Duodenal Obstruction  

Cho, Jun-Hyung (Department of Internal Medicine, Kyunghee University College of Medicine)
Dong, Seok-Ho (Department of Internal Medicine, Kyunghee University College of Medicine)
Cho, Chang-Hyun (Department of Internal Medicine, Kyunghee University College of Medicine)
Jang, Jae-Young (Department of Internal Medicine, Kyunghee University College of Medicine)
Kim, Hyo-Jong (Department of Internal Medicine, Kyunghee University College of Medicine)
Kim, Byung-Ho (Department of Internal Medicine, Kyunghee University College of Medicine)
Chang, Young-Woon (Department of Internal Medicine, Kyunghee University College of Medicine)
Chang, Rin (Department of Internal Medicine, Kyunghee University College of Medicine)
Publication Information
Clinical Endoscopy / v.42, no.3, 2011 , pp. 195-200 More about this Journal
Abstract
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.
Keywords
Argon plasma coagulation; Metallic stent; Trimming;
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1 Kundu R, Pleskow D. Biliary and pancreatic stents: complications and management. Tech Gastointest Endosc 2007;9:125-134.   DOI   ScienceOn
2 Kahaleh M, Tokar J, Conaway M, et al. Efficacy and complications of covered Wallstents in malignant distal biliary obstruction. Gastrointest Endosc 2005;61:528-533.   DOI   ScienceOn
3 Kahaleh M, Tokar J, Le T, Yeaton P. Removal of self-expandable metallic Wallstents. Gastrointest Endosc 2004;60:640-644.   DOI   ScienceOn
4 Ahmed A, Keeffe EB, Imperial JC. A novel technique for endoscopic removal of expandable biliary Wallstent. Gastrointest Endosc 1999;50:279-281.   DOI   ScienceOn
5 Egan LJ, Baron TH. Endoscopic removal of an embedded biliary Wallstent by piecemeal extraction. Endoscopy 2000;32:492-494.   DOI   ScienceOn
6 Levy MJ, Wiersema MJ. Endoscopic removal of a biliary Wallstent with a suture-cutting device in a patient with primary pancreatic lymphoma. Endoscopy 2002;34:835-837.   DOI   ScienceOn
7 Schwartz R, Zera R, Cass O. Laser endosurgery on biliary wire mesh stents. Gastrointest Endosc 1993;39:735-736.   DOI   ScienceOn
8 Yarze JC, Poulos AM, Fritz HP, Herlihy KJ. Treatment of metallic biliary stent-induced duodenal ulceration using endoscopic laser therapy. Dig Dis Sci 1997;42:6-9.   DOI   ScienceOn
9 Demarquay JF, Dumas R, Peten EP, Rampal P. Argon plasma endoscopic section of biliary metallic prostheses. Endoscopy 2001;33:289-290.   DOI   ScienceOn
10 Vargo JJ. Clinical applications of the argon plasma coagulator. Gastrointest Endosc 2004;59:81-88.   DOI   ScienceOn
11 Vanbiervliet G, Piche T, Caroli-Bosc FX, et al. Endoscopic argon plasma trimming of biliary and gastrointestinal metallic stents. Endoscopy 2005;37:434-438.   DOI   ScienceOn
12 Chen YK, Jakribettuu V, Springer EW, Shah RJ, Penberthy J, Nash SR. Safety and efficacy of argon plasma coagulation trimming malpositioned and migrated biliary metal stents: a controlled study in the porcine model. Am J Gastroenterol 2006;101:2025-2030.   DOI   ScienceOn
13 Guda NM, Freeman ML. Endoscopic transection of distally migrated biliary self-expanding metallic stents by using argon plasma coagulation: a report of 2 cases (with video). Gastrointest Endosc 2006;63:512-514.   DOI   ScienceOn
14 Rerknimitr R, Naprasert P, Kongkam P, Kullavanijaya P. Trimming a metallic biliary stent using an argon plasma coagulator. Cardiovasc Intervent Radiol 2007;30:534-536.   DOI   ScienceOn
15 Wong Kee Song LM. Management of colonic stent-induced luminal obstruction using argon plasma coagulation. Am J Gastroenterol 2006;101:228S.
16 Kwon JH, Lee IS, Park JM, et al. Endoscopic argon plasma laser trimming of biliary self expanding metallic stent. Korean J Gastrointest Endosc 2006;33:385-389.
17 Witte TN, Danovitch SH, Borum ML, Irani SK. Endoscopic trimming of a rectal self-expanding metallic stent by use of argon plasma coagulation. Gastrointest Endosc 2007;66:210-211.   DOI   ScienceOn
18 Christiaens P, Decock S, Buchel O, et al. Endoscopic trimming of metallic stents with the use of argon plasma. Gastrointest Endosc 2008;67:369-371.   DOI   ScienceOn
19 Auroux J, Roblin X, Germain E, Berthelet O, Bichard P. An uncommon use of argon plasma coagulation: endoscopic transection of self-expanding metallic stents. Gastroenterol Clin Biol 2008;32:118-122.   DOI   ScienceOn
20 Molina-Infante J, Mateos-Rodriguez JM, Fernandez-Bermejo M, Perez-Gallardo B, Hernandez-Alonso M. Endoscopic trimming of an embedded distally migrated metallic rectal stent with argon plasma coagulation. Surg Laparosc Endosc Percutan Tech 2010;20:e73-e75.   DOI   ScienceOn