Intrahepatic Plastic Stent Entrapment Due to Guide Wire Stripping

Excerpt

During endoscopic retrograde cholangiopancreatography (ERCP) of a 56-year-old female patient on the periodic stent exchange program due to benign biliary stricture treatment, it was realized that the guide wire could not be pulled out after insertion of a 7-F biliary stent in the right intrahepatic duct. There was a thickening and deformity at the distal tip of the guide wire during scopic control and it was thought that the knotting of the guide wire prevented the guide wire from being pulled off (Fig. 1). The only solution of the problem was to extract the stent together with guide wire and so we used a Soehendra stent retriever (Wilson Cook Medical, Winston-Salem, NC) over the guide wire. The procedure was completed without extraction of the endoscope; multiple stent insertions were performed. The problem was not knotting of the tip, but the material (PTFE) which covers the tip of guide wire was stripped and metallic wire under the cover cut the proximal end of the Amsterdam-type plastic stent and embedded in it (Fig. 2). It was thought that the possible reason of the problem was the wearing of the guide wire due to reuse.

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