Forgotten CBD stent (102 months) with stone-stent complex: A case report

Area of Science:

• Gastroenterology
• Surgical Innovation
• Medical Device Complications

Background:

• Choledocholithiasis, or common bile duct stones, can be managed via endoscopy or surgery.
• Retained foreign bodies, such as biliary stents, can act as a nidus for stone formation, leading to symptoms like pain, fever, and jaundice.

Purpose of the Study:

• To highlight the potential complications associated with retained biliary stents.
• To emphasize the importance of timely stent removal in preventing adverse outcomes.

Main Methods:

• A case presentation of a 60-year-old female patient with cholangitis, common bile duct stones, and a stent in situ.
• Diagnostic imaging (CT scan) revealed a cholangitic abscess, dilated common bile duct, and sludge around the stent.
• Surgical exploration identified a stone at the proximal end of the stent.

Main Results:

• Retained stents, while sometimes asymptomatic, can migrate or form a nidus for stone development.
• Prolonged stent presence can lead to bacterial proliferation, biofilm formation, and calcium bilirubinate precipitation, manifesting as fever, pain, and jaundice.
• The stent-stone complex was successfully treated through both endoscopic and surgical interventions.

Conclusions:

• Biliary stents carry risks including stone formation and infection, necessitating careful monitoring and timely removal.
• Patients should be informed of potential stent-related complications and advised on regular follow-up and adherence to removal schedules, typically around 6 weeks post-insertion.