Diagnoais : Benign bile duct stricture due to migrated P-J stomy site stent

영상 해설

수술 직후 영상에서 pancreatic duct 내로 P-J stomy tube가 위치한 것을 볼수 있다

그 후 증상 발현시에는 P-J stomy stent가 CBD를 거쳐 right IHD쪽으로 migration한 것을 볼 수 있다.

그 로 인하여 그 주변 stricture가 유발되었다.

Discussion

Internal stenting of the pancreaticojejunostomy (PJ) has
been widely used to reduce the pancreatic fistula rate, although its efficacy is still debatable. Internal PJ stents are
generally assumed to pass spontaneously into the small intestine and eventually pass uneventfully through the rectum.

Stent migration into the bile ducts occurred in 135 patients (16.8 %); 40 of these (29.6 %) showed stent-induced
complications including bile duct stricture, stone, and liver abscess.

 Neither the stent length nor diameter was associated with stent migration. A small stent diameter, peripheral
location of the stent, absence of stent remigration from the bile ducts to the intestine, and longer stent retention time in the bile
ducts were risk factors of stent-induced complications.