Duodenal obstruction by self-expanding biliary stents in patients with pancreatic cancer

Self-expanding biliary drains seem to allow long-term patency and prevent stent migration in peri-ampullary neoplastic lesions. We report two cases of duodenal occlusions due to the stent advancing towards the intestinal lumen in patients with tumours of the pancreatic head. The stents had been percutaneously positioned after an endoscopic papillotomy or palliative choledocho-jejunostomy and were impacted by alimentary debris, blocking the passage of food. Dislodgement of the metallic mesh, in conjunction with duodenal wall stiffness and reduced absorption ability due to the pancreatic cancer, can give rise to progressive intestinal occlusion.