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

Figure 4

Complete stent fractures at two locations in an 82-year-old man with pancreatic cancer. (a). Percutaneous transhepatic cholangiogram demonstrating a stricture in the distal common bile duct was shown. Biliary decompression was performed with placement of a drainage catheter by the routine right approach. (b, c). Eight weeks later, a metallic self-expandable stent (diameter, 8 mm; length, 80 mm; COOK Inc., Bloomington, IN, United States) was inserted. Contrast medium injection after stent placement revealed stent patency. The distal part of the stent protruded into the duodenum. Postdilation was performed. (d). After 179 days, the patient developed recurrent jaundice. Percutaneous transhepatic cholangiography showed stent occlusion. There were two complete fracture sites in the metallic biliary stent (arrow), located at the upper biliary stenosis and duodenal ampulla, respectively.

(a)

(b)

(c)

(d)