Gastric Outlet Obstruction Caused by a Migrated Biliary Stent: A Review of Published Cases

Abstract

Background: Biliary stent migration is the commonest mechanical failure of endoscopic stenting. Gastric outlet obstruction
appears in complication lists and individual reports but has never been counted. Objective: To set out what the published record contains on gastric outlet obstruction from a migrated stent, against the well-measured parent complication.
Methods: Narrative review of published cohort studies, pooled case analyses and individual case reports.Findings: Migration rates  across cohorts were consistent, from 74 of 876 stented patients (8.4%) to 11.4% of 295 plastic stents. Only three published records involve the gastroduodenal outlet, and in all three the duodenum was narrowed by tumour, so the stent was not clearly the obstructing object. No study reports a denominator for this complication. Conclusions: The published record supports imaging the vomiting patient and searching widely for the stent; it does not support any rate for outlet obstruction, which remains reported and unmeasured.