The silent stent ascent: asymptomatic retrograde migration of pancreatic duct stent post-pancreaticoduodenectomy

Abstract

Transanastamotic stents are used to maintain pancreatic duct patency post Whipple’s procedure to manage postoperative fistulas. We present a rare case of a 54-year-old male who presented with recurrent epigastric pain and vomiting post pancreaticoduodenectomy. Imaging demonstrated incidental pancreatic stent migration through the hepaticojejunostomy into the left biliary tree, without evidence of cholangitis. Pancreatic stent in a Whipple’s procedure, demonstrates benefits in maintaining pancreatic duct patency and reduces pancreatic fistulisation. However, it is associated with potential complications including proximal stent migration into the biliary tree. In our case, the patient remained asymptomatic which makes it a unique case. The necessity of stent removal in asymptomatic cases remains a subject of consideration. However, the endoscopic retrieval is in preference to avoid surgical intervention to avoid the risks and complications of invasive procedures.