[Percutaneous transhepatic retrieval of an intraoperatively displaced biliary stent]

Biliary stents play an important role in the treatment of jaundice due to malignant and/or benign diseases of the bile duct. Biliary stents are primarily introduced endoscopically whereas the percutaneous transhepatic technique is employed after endoscopic failure. Proximal and distal displacement or migration is a rare complication, but there is a risk of considerable morbidity and mortality, so that the extraction of the prosthesis is recommended in these cases. Again, endoscopic removal is the approach of choice. For stent retrieval multiple techniques have been described, including Dormia basket, special forceps, Fogarty balloon catheter, ball tip catheter and loop catheter. Endoscopic recovery often uses a combination of these techniques reaching a success rate of 90%. However, in patients following hepaticojejunostomy or Bilroth II procedure an endoscopic retrieval cannot be performed for obvious technical reasons. Consequently, percutaneous transhepatic stent removal must be considered. Ensuring a correct technique transhepatic removal is equally successful and safe, thus eliminating the risks of a surgical procedure.