Plastic Surgery: Cholangioscopic Intra-stent Balloon Retrieval of a Proximally Migrated Biliary Stent
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Case Presentation and Evolution
A 41-year-old man with a benign bile duct stricture was initially evaluated at our institution for endoscopic retrograde cholangiopancreatography (ERCP) with biliary stent exchange following plastic stent placement at an outside facility 2 months previously. His past medical history was notable for a motor vehicle accident resulting in abdominal crush injury and portal vein thrombosis. He then developed portal hypertension complicated by bleeding esophageal and gastric varices managed by splenectomy, with the creation of a mesocaval shunt. Due to subsequent stenosis of the mesocaval shunt, he underwent portal vein thrombectomy and remained on warfarin therapy. He additionally developed portal biliopathy with a distal common bile duct stricture managed by stent placement.
Vital signs at the time of his procedure were notable for a heart rate of 82 beats/min, temperature of 37.2 °C, blood pressure of 101/72 mm of Hg, and respiratory rate of 11/min....