Migration of a Common Bile Duct Stone into the Main Pancreatic Duct due to Catheter Manipulation during Endoscopic Retrograde Cholangiopancreatography.

IF 0.5 Q4 GASTROENTEROLOGY & HEPATOLOGY Case Reports in Gastroenterology Pub Date : 2024-03-26 eCollection Date: 2024-01-01 DOI:10.1159/000538009

Toji Murabayashi, Haruka Nakamura, Shinya Sugimoto

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Abstract

Introduction: We report the first case of a choledocholithiasis migrating into the main pancreatic duct (MPD) due to catheter manipulation during endoscopic retrograde cholangiopancreatography (ERCP).

Case presentation: A 57-year-old woman complaining of vomiting was diagnosed with acute cholangitis and pancreatitis due to choledocholithiasis. During ERCP, the stone migrated from the papilla into the MPD due to the pushing motion of the catheter. However, the ERCP session was completed after biliary sphincterotomy without intervention in the MPD because the migration was not noticed. The migrated stone became apparent on computed tomography the following day. The second ERCP revealed the stone measuring 5 mm in the MPD. After pancreatic sphincterotomy, a pancreatic stent was placed, which improved the obstructive pancreatitis.

Conclusion: Endoscopists performing ERCP should be aware of this rare but serious complication.

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内镜逆行胰胆管造影术中导管操作导致胆总管结石移入主胰管。

导言：我们报告了首例在内镜逆行胰胆管造影术（ERCP）中因导管操作导致胆总管结石移入主胰管（MPD）的病例：一名57岁的妇女主诉呕吐，被诊断为胆总管结石引起的急性胆管炎和胰腺炎。在ERCP过程中，由于导管的推送动作，结石从乳头移入MPD。然而，ERCP手术在胆道括约肌切开术后完成，没有对MPD进行干预，因为没有发现结石移位。第二天的计算机断层扫描显示结石移位。第二次ERCP检查发现，结石在MPD中的大小为5毫米。胰腺括约肌切开术后，放置了胰腺支架，改善了梗阻性胰腺炎：结论：实施ERCP的内镜医师应注意这种罕见但严重的并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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