Late Pancreaticojejunostomy Stent Migration and Hepatic Abscess after Whipple Procedure

A previously unreported late complication of a transanastomotic stent across a pancreaticotojejunostomy is described. The stent migrated distally into the jejunal lumen, through the biliary anastomis into the bile duct and proximally into the liver where it served as a nidus for infection with abscess formation. A percutaneous transhepatic interventional radiologic approach both drained the abscess and pushed the stent out of the liver and biliary tree and into the bowel, with complete recovery. The decision by the surgeon to use a stent in these patients is discussed, and the complications associated with stenting a pancreaticojejunostomy are reviewed.

Key Words: stent, pancreaticoduodenectomy, hepatic abscess, panceaticojejunostomy

Competency: Patient Care, Medical Knowledge, Practice Based Learning and Improvement