A novel approach: a pancreatic duct stent removable with the nasobiliary catheter

Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is one of the most common complications of ERCP. Prophylactic pancreatic duct (PD) stent placement is an effective measure to reduce its incidence [1]. However, conventional PD stents require follow-up X-rays for the confirmation of spontaneous dislodgement or a second endoscopy for removal, which imposes additional patient discomfort and financial burden [2]. We designed a novel method that allows for the simultaneous removal of a PD stent along with a nasobiliary catheter (NBC) at the bedside, based on clinical needs.

A 36-year-old woman presented with abdominal pain. Magnetic resonance cholangiopancreatography confirmed choledocholithiasis, and she was scheduled for ERCP ([Video 1]). Pre-procedure preparation: The NBC and PD stent were pre-modified by tying a surgical suture at their marked positions, forming a loop of approximately 1.5 cm in diameter ([Fig. 1] a, b). During the ERCP procedure, the guidewire was first advanced into the pancreatic duct and was subsequently retained.

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Demonstration of the novel technique for the simultaneous removal of the pancreatic duct stent and nasobiliary catheter after endoscopic retrograde cholangiopancreatography.Video 1

Fig. 1 An innovative method: a pancreatic duct stent for removal alongside the nasobiliary catheter. a The surgical suture tied at the marked site of the nasobiliary catheter, and the suture loop diameter is 1.5 cm. b The surgical suture tied at the marked site of the pancreatic duct stent, and the suture loop diameter is 1.5 cm. c Placement of the pancreatic duct stent with the tied suture. d Placement of the nasobiliary catheter with the tied suture. e Titanium clips used to connect the nasobiliary catheter and pancreatic duct stent. f The nasobiliary catheter and pancreatic duct stent connection device.

Using the double-guidewire technique, the bile duct was successfully cannulated ([Video 1]). The modified PD stent was deployed over the pancreatic guidewire ([Fig. 1] c). Following balloon extraction of the common bile duct stones ([Video 1]), the modified NBC was placed ([Fig. 1] d). A titanium clip was used to securely link the suture loops of the NBC and the PD stent ([Fig. 1] e). At 48 hours post-procedure, the patient recovered well with no complications such as PEP, bleeding, or infection. The connected NBC-PD stent assembly was removed gently and completely at the bedside ([Video 1], [Fig. 1] f).

This connected NBC-PD stent assembly offers dual benefits: it secures the PD stent to prevent premature migration and enables its convenient, simultaneous removal with the NBC. This technique effectively obviates the need for additional imaging studies or a repeat endoscopy, presenting a representing and clinically advantageous approach worthy of broader adoption.

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Contributorsʼ Statement

Haiyong Long: Conceptualization, Data curation, Writing – original draft. Ping Wang: Conceptualization. Wenguang Yang: Conceptualization, Resources. Yuhong Ren: Conceptualization, Software. Bin Yang: Conceptualization, Data curation, Software. Sichao Wen: Conceptualization, Data curation, Software. Mingwen Guo: Conceptualization, Writing – review & editing.

Conflict of Interest

The authors declare that they have no conflict of interest.

• References

• 1 Dumonceau JM, Kapral C, Aabakken L. et al. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2020; 52: 127-149
• 2 Kahaleh M, Freeman M. Prevention and management of post-endoscopic retrograde cholangiopancreatography complications. Clin Endosc 2012; 45: 305-312

Publication History

Article published online:
08 January 2026