{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T04:20:44Z","timestamp":1767846044874,"version":"3.49.0"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T00:00:00Z","timestamp":1603238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002Perforation of the duodenal wall opposing the major papilla due to a migrated pancreatobiliary stent rarely has been described in the literature as a complication of endoscopic retrograde cholangiopancreatography (ERCP). Factors associated with perforation from migrated stents from ERCP are unknown. <\/jats:p><jats:p>\n          Patients and methods\u2002This was a retrospective, observational study. Patients were identified from January 1, 1994 to May 31, 2019 in a prospectively maintained ERCP database. <\/jats:p><jats:p>\n          Results\u2002Eleven cases of duodenal perforation from migrated pancreatobiliary stents placed at ERCP were identified during the study period. All cases involved biliary stents, placed for biliary stricture management. The perforating stent was plastic in 10 cases (91\u200a%). This complication occurred in one in 2,293 ERCP procedures in which a pancreatobiliary stent was placed. <\/jats:p><jats:p>\n          Conclusion\u2002This complication is more common with biliary stents compared to pancreatic stents. This may be related to the angle of exit of biliary stents being more perpendicular to the opposing duodenal wall and the near exclusive use of external pigtail plastic stents in the pancreatic duct. All perforating plastic stents were\u200a\u2265\u200a9\u200acm in length. Longer stents may provide leverage for perforation with a migration event.<\/jats:p>","DOI":"10.1055\/a-1231-4758","type":"journal-article","created":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T22:51:07Z","timestamp":1603320667000},"page":"E1530-E1536","source":"Crossref","is-referenced-by-count":12,"title":["A rare complication of ERCP: duodenal perforation due to biliary stent migration"],"prefix":"10.1055","volume":"08","author":[{"given":"Mark A.","family":"Gromski","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin L.","family":"Bick","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Vega","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey J.","family":"Easler","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James L.","family":"Watkins","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart","family":"Sherman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glen A.","family":"Lehman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan L.","family":"Fogel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,10,21]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/S0016-5107(92)70429-5","article-title":"Incidence and risk factors for biliary and pancreatic stent migration","volume":"38","author":"J F Johanson","year":"1992","journal-title":"Gastrointest 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perforation and biliary peritonitis","volume":"5","author":"H Issa","year":"2013","journal-title":"World J Gastrointest Endosc"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/SLE.0b013e3181a031f5","article-title":"Migration of plastic biliary stents and endoscopic retrieval: an experience of three referral centers","volume":"19","author":"P Katsinelos","year":"2009","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1016\/j.gie.2014.08.003","article-title":"Duodenal perforation secondary to migrated biliary stent in a liver transplant patient: successful endoscopic closure with an over-the-scope clip","volume":"81","author":"M Kriss","year":"2015","journal-title":"Gastrointest Endosc"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1097\/SLE.0b013e318185a07a","article-title":"A devastating complication: duodenal perforation due to biliary stent migration","volume":"18","author":"C H Lo","year":"2008","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"ref9","first-page":"385","article-title":"Duodenal perforation secondary to biliary stent dislocation: a case report and review of the literature","volume":"57","author":"G Melita","year":"2005","journal-title":"Chir Ital"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.cursur.2005.03.011","article-title":"Retroperitoneal perforation of the duodenum from biliary stent erosion","volume":"62","author":"G Miller","year":"2005","journal-title":"Curr Surg"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"351","DOI":"10.2169\/internalmedicine.9054-17","article-title":"Retroperitoneal perforation caused by migration of a pancreatic spontaneous dislodgement stent into periampullary diverticula","volume":"57","author":"M Nishiwaki","year":"2018","journal-title":"Intern Med"},{"key":"ref12","first-page":"387","article-title":"Migrated biliary stent predisposing to fatal ERCP-related perforation of the duodenum","volume":"15","author":"D Paikos","year":"2006","journal-title":"J Gastrointestin Liver Dis"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/j.gie.2012.01.036","article-title":"Duodenal perforation due to plastic stent migration successfully treated by endoscopy","volume":"75","author":"V Prachayakul","year":"2012","journal-title":"Gastrointest Endosc"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/S0016-5107(00)70454-8","article-title":"Clip closure of a duodenal perforation secondary to a biliary stent","volume":"51","author":"L L Roses","year":"2000","journal-title":"Gastrointest Endosc"},{"key":"ref15","first-page":"154","article-title":"Biliary stent migration with duodenal perforation","volume":"40","author":"M Yaprak","year":"2008","journal-title":"Eurasian J Med"}],"container-title":["Endoscopy International 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