Minimally Invasive Retrieval of a Migrated Duodenal Stent

Background: Self-expanding metal and covered metal stents (SEMS) commonly relieve malignant gastric outlet obstruction. In benign disease their use is limited. While disease progression and tumor ingrowth limit migration of duodenal stents in malignancy, stents placed for benign disease are more likely to migrate. When needed, laparotomy has been used to retrieve migrated stents. We summarize a case and the rationale for laparoscopic stent retrieval. Methods: A 62 year old female had a coated metal duodenal stent placed endoscopically after failure of medical management for a duodenal stricture secondary to peptic ulcer disease. This stent migrated and impacted in the mid jejunum and could not be retrieved endoscopically. Laparoscopic retrieval was successful and without complication Results: Oral intake was resumed on postoperative day 4. No intraoperative or postoperative complications occurred. Conclusions: Laparoscopic retrieval of a migrated duodenal stent is a safe and feasible approach, and should be considered when migrated, symptomatic stents are beyond the reach of endoscopes and warrant retrieval.