BALLOON TRAWL; A SAFE AND EFFECTVE WAY OF REMOVING COMMON BILE DUCT (CBD) EMBEDDED STENTS

Biliary stenting has been used since the 1970s to relieve biliary obstruction for a variety of causes including benign and malignant biliary strictures. Migration of stents proximally into the biliary tree or distally into the intestinal tract is relatively uncommon. We report a case of a 64-year-old female with a peri-ampullary tumour, who had symptomatic obstructive jaundice following endoscopic retrograde cholangiopancreatography and plastic stent insertion. Follow-up imaging showed proximal migration of the plastic stent and blockage of the distal common bile duct (CBD) secondary to the periampullary tumour. The biliary stent was safely removed endoscopically using balloon trawl. This case highlights that, while biliary stenting for strictures is generally safe and effective, stent migration to proximal CBD can occur. Balloon trawl is safe and effective way of removing such stents. Key words: Biliary stricture, common bile duct, endoscopic retrograde cholangiopancreatography, periampullary tumour, stents