BALLOON TRAWL; A SAFE AND EFFECTVE WAY OF REMOVING COMMON BILE DUCT (CBD) EMBEDDED STENTS

Biliary stenting has been used since the 1970’s to relieve biliary obstruction for a variety of causes including benign and malignant biliary strictures (1). Migration of stents proximally into the biliary tree or distally into the intestinal tract is relatively uncommon (2). We report a case of a 64 year old female with a peri-ampullary tumour, who had symptomatic obstructive jaundice following ERCP and plastic stent insertion. Follow up imaging showed proximal migration of the plastic stent and blockage of the distal CBD secondary to the peri-ampullary tumour. The biliary stent was safely removed endoscopically using balloon trawl. This case highlights that while biliary stenting for strictures is generally safe and effective, but stent migration to proximal CBD can occur. Balloon trawl is safe and effective way of removing such stents.