ArticleVideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy2026
Pancreatoscopy-guided laser segmentation for retrieval of an upstream-migrated pancreatic duct stent in a meandering duct.
Article in VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
4 authors.
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Abstract
Background and Aims: Upstream migration of pancreatic duct (PD) stents is an uncommon adverse event and may be particularly challenging in the presence of variant ductal anatomy such as a meandering main PD (MPD). We describe an endoscopic approach using laser-assisted pancreatoscopy for the retrieval of an upstream-migrated PD stent. Methods: A 60-year-old woman with a previously placed 5F single-pigtail PD stent was found to have upstream migration into a meandering MPD, with the pigtail tip impacted in a side branch of the uncinate process. Multiple conventional endoscopic retrieval attempts were unsuccessful. Results: Pancreatoscopy enabled direct visualization of the impacted stent. Before intraductal application, ex vivo trial laser cuts were performed on an identical polyether block amide pancreatic stent to assess laser/material interaction. Laser segmentation was subsequently performed intraductally under continuous saline irrigation using incremental energy settings. Stent fragments were successfully retrieved using pancreatoscopic forceps. Postprocedural pancreatoscopy demonstrated no ductal injury or ductal dehiscence. Conclusions: Laser-assisted pancreatoscopic segmentation facilitated safe endoscopic retrieval of an upstream-migrated pancreatic stent in complex ductal anatomy and may offer a minimally invasive alternative to surgery in select cases.
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