Unnoticed for 14 years: an asymptomatic forgotten common bile duct stent - a case report.

Introduction: Choledocholithiasis is the presence of gallstones within the common bile duct (CBD), affecting 10-20% of gallbladder stone patients. Endoscopic retrograde cholangiopancreatography (ERCP) with stent insertion is a common treatment of CBD obstruction and stenosis to maintain duct patency, with stents typically replaced within 3-6 months. However, prolonged stent presence can lead to complications such as pancreatitis and cholangitis. We report a rare case of a neglected CBD stent left in situ for 14 years without complications. Case presentation: A 77-year-old female with controlled hypertension and diabetes presented to the hospital for a routine check-up. Physical examination was unremarkable except for mild scleral jaundice. She had a history of obstructive jaundice treated with ERCP and stent placement in 2010 but missed follow-ups for stent replacement. Laboratory tests revealed mildly elevated total bilirubin and low serum albumin. An abdominal ultrasound showed gallbladder sludge and a mildly dilated CBD. ERCP confirmed a dilated CBD and common hepatic duct stricture. A new plastic stent was placed, with follow-up ERCP scheduled every 6 months. Clinical discussion: Forgotten biliary stents (FBS) are plastic stents left in place for more than a year. They can cause complications such as cholangitis, jaundice, stent migration, and pancreatitis. Elderly patients are more susceptible due to physical limitations and potentially inadequate follow-up. Our case highlights the unusual presentation of an asymptomatic FBS for 14 years. Conclusion: This case emphasizes the importance of regular monitoring and timely stent replacement to prevent complications. Effective patient education and adherence to follow-up protocols are crucial in managing biliary stents.