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13 December 2019 : Case report  Saudi Arabia

Retrograde Pancreatic Duct Stent Migration into the Biliary Tract Presenting as a Rare Early Complication of Pancreaticoduodenectomy (Whipple Procedure)

Unusual clinical course, Unusual or unexpected effect of treatment

Mayar Helaly1E, Dalia Sriwi1E, Wijdan S. Alkholaidi1F, Raghed Almamlouk1EF*, Amany Elshaer1EF, Ranem M. Allaboon1E, Lamma H. Hassan1E, Hisham Khalifa23A, Ihssan Al-Alem2A

DOI: 10.12659/AJCR.917297

Am J Case Rep 2019; 20:1864-1868


BACKGROUND: Pancreaticoduodenectomy (Whipple procedure) is an established surgical procedure for the treatment of carcinoma of the head of the pancreas. Modifications to this procedure include gastropancreaticoduodenectomy, which includes the removal of parts of the pancreas, duodenum, and stomach. Complications of surgery include fistula formation, failure of the anastomosis, and leak of pancreatic enzymes, which can be reduced by stenting the pancreatic duct. This report is of a rare complication of pancreaticoduodenectomy and describes a case of retrograde migration of a pancreatic duct stent into the biliary tract through the orifice of the hepaticojejunostomy.

CASE REPORT: A 50-year-old man with a history of gastric cancer, underwent gastropancreaticoduodenectomy. Surgery was complicated by displacement of the pancreatic stent to the biliary system, which resulted in postoperative obstructive jaundice and bile leakage from the hepaticojejunostomy between the hepatic duct and the jejunum. An endoscopy was performed and the stent was successfully retrieved. The patient recovered rapidly, the bile leakage resolved, the patient’s jaundice resolved, and was discharged home with no further surgical complications.

CONCLUSIONS: A case is reported of a rare early complication of pancreaticoduodenectomy in a patient with gastric cancer. Endoscopy successfully retrieved the pancreatic duct stent that had migrated into the biliary tract through the orifice of the hepaticojejunostomy.

Keywords: Gastrointestinal Neoplasms, Pancreaticoduodenectomy, Postoperative Complications, Biliary Tract, Bile Ducts, Device Removal, Foreign-Body Migration, Middle Aged, Pancreatic Ducts, Stents

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923