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A 95-year-old woman had a 10mm×6cm fully covered biliary stent implanted at another hospital to treat lower common bile duct stenosis caused by biliary neoplasm. Sixmonths later, the stent became dislodged and migrated into the small intestine. Another uncovered biliary stent was inserted to replace it. She was kept under observation because of performance status 4; however, nausea and vomiting continued, and small intestinal obstruction caused by the migrated stent was suspected. She was later referred to our department for recovery. Computed tomography showed that the biliary stent had migrated to the ascending colon (▶Fig. 1); its recovery via colonoscopy was attempted. Colonoscopy revealed a circumferential stenosis caused by type 2 advanced colon cancer (▶Fig. 2), and gastrografin enterography revealed retention of the migrated stent in the cecum (▶Fig. 3). Owing to the perforation risk [1–5], we decided to relieve the obstruction with a colonic stent not only for palliative purposes but also for recovery of the biliary stent. On Day 3 post-admission, a newly developed 8-cm colonic stent with a 9-Fr delivery system and a 22-mm diameter was placed through the scope using a slim-caliber colonoscope (▶Fig. 4). On Day 7, a short-type double-balloon endoscope, fitted with an overtube, was used to recover the migrated stent. The colonic stent was well dilated, and the overtube passed through without resistance. The biliary stent was visible immediately after passing the stenosis. Its tip was grasped with a grasping forceps, and it was recovered successfully (▶Fig. 5, ▶Video1). E-Videos

Use of a colonic stent to recover a biliary stent retained by malignant colonic obstruction