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DOI: 10.1055/a-2625-3711
Suture-loop anchoring at the distal end of a pancreatic stent: a novel approach to prevent proximal migration
Proximal migration of pancreatic stents, though rare (0.2%) [1], remains a serious complication of endoscopic retrograde cholangiopancreatography (ERCP) that requires complex retrieval methods including endoscopic grasping, pancreatoscopy, or surgery [2]. Recent advances include endoscopic ultrasound (EUS)-guided retrieval [3], yet these approaches demand expertise and resources.
We propose an innovative preventive strategy. An absorbable suture is threaded through the terminal side hole, and the length of the suture after knotting is kept at approximately 3 cm ([Fig. 1] a). The video documents a 78-year-old jaundiced patient in whom a trainee inadvertently deployed a 5-Fr stent deeply into the pancreatic duct ([Fig. 1] b). The supervising physician grasped the externalized suture with rat tooth forceps ([Fig. 1] c, [Video 1]), successfully repositioning the stent ([Fig. 1] d) and enabling subsequent biliary stenting. This suture-loop technique provides a simple yet reliable solution for preventing pancreatic stent migration. The technique is particularly suitable for trainees and is recommended for widespread clinical adoption.
Endoscopy_UCTN_Code_TTT_1AR_2AZ
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Conflict of Interest
The authors declare that they have no conflict of interest.
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References
- 1 Cai YL, Wang F, Zhang J. et al. Incidence, risk factors and endoscopic retrieval of proximally migrated pancreatic stents: 25 years of experience in a high-volume center – a case controlled study. Int J Surg 2025; 111: 3115-3119
- 2 Jayanna SH, Bush N, Sharma R. et al. Endoscopic removal of proximally migrated pancreatic duct stents: a case series and literature review. Ann Gastroenterol 2025; 38: 230-236
- 3 Akiyama S, Tanke G, Inokuma T. Successful retrieval of a migrated pancreatic stent via endoscopic ultrasound-guided transluminal drainage using an ultraslim upper endoscope. Dig Endosc 2025;
Correspondence
Publikationsverlauf
Artikel online veröffentlicht:
14. Juli 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
Georg Thieme Verlag KG
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References
- 1 Cai YL, Wang F, Zhang J. et al. Incidence, risk factors and endoscopic retrieval of proximally migrated pancreatic stents: 25 years of experience in a high-volume center – a case controlled study. Int J Surg 2025; 111: 3115-3119
- 2 Jayanna SH, Bush N, Sharma R. et al. Endoscopic removal of proximally migrated pancreatic duct stents: a case series and literature review. Ann Gastroenterol 2025; 38: 230-236
- 3 Akiyama S, Tanke G, Inokuma T. Successful retrieval of a migrated pancreatic stent via endoscopic ultrasound-guided transluminal drainage using an ultraslim upper endoscope. Dig Endosc 2025;