Duodenal Perforation From Dislodged Prophylactic Pancreatic Stent Following ERCP for Hilar Cholangiocarcinoma: A Rare Adverse Event.

Mina Alkomos, Jolie Ibrahim, Karan Desai, Beshoy E Elkomos, Walid Baddoura, Youssef Botros

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Article in Journal of community hospital internal medicine perspectives, 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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6 authors.

Mina AlkomosGastroenterology Department, Saint Joseph's University Medical Center, Paterson, NJ, USA.ORCID https://orcid.org/0000-0002-7669-1173

Jolie IbrahimInternal Medicine Department, Ain Shams University, Cairo, Egypt.

Karan DesaiGastroenterology Department, Saint Joseph's University Medical Center, Paterson, NJ, USA.

Beshoy E ElkomosGeneral and Colorectal Surgery Department, Royal United Hospital, Bath, UK.

Walid BaddouraGastroenterology Department, Saint Joseph's University Medical Center, Paterson, NJ, USA.

Youssef BotrosGastroenterology Department, Saint Joseph's University Medical Center, Paterson, NJ, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We report a rare complication of prophylactic pancreatic duct stenting during ERCP for suspected hilar cholangiocarcinoma. A 47-year-old woman presented with two weeks of painless jaundice, total bilirubin 18 mg/dL, and cholestatic enzymes. Imaging revealed intrahepatic biliary dilation without CBD dilation. ERCP with cholangioscopy identified a right hepatic duct stricture; biopsies were obtained. A 10 mm × 4 cm covered metal stent was placed in the CBD, a 7 Fr × 12 cm plastic stent in the right hepatic duct, and a 4 Fr × 5 cm pancreatic stent was prophylactically inserted after inadvertent duct cannulation. Two days later, she developed acute abdominal pain. CT revealed stent migration with duodenal perforation. Repeat ERCP removed the dislodged stent, closed the defect endoscopically, and replaced the metal biliary stent with plastic. Biopsies confirmed perihilar cholangiocarcinoma. This case emphasizes that although prophylactic stenting reduces the risk of post-ERCP pancreatitis, migration and perforation can occur, underscoring the importance of vigilance and early recognition of post-procedural complications.

Indexed as

ERCPHilar cholangiocarcinomaPancreatic stentPerforation

Identifiers

PMID42683034

DOI10.55729/2000-9666.1610

PMCPMC13532666

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