Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary Obstruction

Figure 1

A 62-year-old male patient with pancreatic carcinoma whose common bile duct was severely obstructed by compression from pancreatic head carcinoma. (a) Contrast medium injection via the percutaneous transhepatic approach showing the distal common bile duct severely obstructed. (b) Five weeks later, a biliary stent (diameter, 10 mm; length, 80 mm; COOK Inc., Bloomington, IN, United States) was deployed in the distal common bile duct. The guidewire can be observed in the distal duodenum. The distal part of the stent protrudes into the duodenum. (c) Because of incomplete dilation of the biliary stent, a balloon (diameter, 8 mm; length, 40 mm; ATB5-35-40-8-4.0; COOK Inc.) was used for biliary-plasty. (d) Eighty-nine days after stent placement, a left percutaneous transhepatic drainage catheter was placed for recurrent biliary obstruction. Cholangiography showed the biliary stent completely fractured (arrow) at the level of the stricture.

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