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

Figure 5

Fracture in a 71-year-old man with common bile duct obstruction secondary to cholangiocarcinoma. (a). Percutaneous transhepatic cholangiogram depicting common bile duct stricture was shown. (b). Two weeks later, a stent (diameter, 10 mm; length, 40 mm; COOK Inc., Bloomington, IN, United States) was inserted into the biliary stricture, above the duodenal ampulla. (c). Nine months after stent placement, the patient developed reobstructive jaundice, and percutaneous cholangiography revealed stent occlusion. Another biliary stent (diameter, 10 mm; length, 100 mm; COOK Inc., Bloomington, IN, United States) was deployed, extending from the duodenum to the convergence of the left and right hepatic ducts. An obtuse angle was formed between the two biliary stents (arrow). (d). One hundred and forty-two days after the second biliary stent implantation, plain X-ray showed the stent fracture located at the duodenal ampulla (arrow).

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