Endoscopic tapered sheath-assisted removal of a proximally migrated pancreatic stent.

Abstract

Endoscopic pancreatic stenting is beneficial for patients with a variety of pancreatic conditions; however, proximal migration of the stent occurs occasionally and removal is technically demanding [1] [2]. It is sometimes quite challenging to pass stent-removal devices such as forceps, baskets, and snares across a stricture, particularly in cases in which the migrated stent is located further away from the pancreatic duct stricture [3]. We present an impressive case in which a new endoscopic tapered sheath (EndoSheather; Piolax, Inc., Kanagawa, Japan) ([Fig. 1]) [4] contributed successfully to the removal of a proximally migrated stent in a patient with a distal stricture. This novel device allowed the stricture to be passed and devices to be inserted easily through an indwelling outer sheath, providing a bridge to the target space even in the deep pancreatic tail.