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Pancreatic Cancer · Journal article
Den Open · June 17, 2026
Raises a question worth testing. It does not answer one.
This case report describes small-bowel impaction caused by mechanical interlocking between a migrated duodenal self-expandable metal stent (SEMS) and biliary plastic stent (PS) in a patient receiving neoadjuvant chemotherapy for pancreatic cancer. The interlocked stents could not be removed endoscopically and required surgical resection.
Case report. A 78-year-old woman with biological borderline resectable pancreatic head cancer (cT2N0M0, stage IB) presenting with obstructive jaundice and gastric outlet obstruction, with prior history of distal gastrectomy (Billroth I reconstruction) 25 years earlier. Intervention: Biliary plastic stent (7-Fr, 9-cm QuickPlace V) and duodenal uncovered SEMS (22 × 80 mm Gentry) with neoadjuvant chemotherapy (gemcitabine plus nab-paclitaxel). n = 1.
A 78-year-old woman with pancreatic head cancer underwent biliary PS (7-Fr, 9-cm) and duodenal SEMS (22 × 80 mm uncovered) placement At 4 months after initiating neoadjuvant chemotherapy, both stents had migrated to the ileum with mechanical interlocking CA19-9 levels decreased from 728.7 IU/mL to 8.8 IU/mL during chemotherapy
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians should be aware that concurrent duodenal metal and biliary plastic stents may mechanically interlock if they migrate together, potentially causing small-bowel impaction that cannot be managed endoscopically. Careful follow-up imaging and timely intervention are warranted when stent migration is detected in patients with multiple stents.
Single case report documenting a rare mechanical complication without generalizable evidence for practice change.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should be aware that concurrent duodenal metal and biliary plastic stents may mechanically interlock if they migrate together, potentially causing small-bowel impaction that cannot be managed endoscopically. Careful follow-up imaging and timely intervention are warranted when stent migration is detected in patients with multiple stents.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Duodenal self-expandable metal stents (SEMS) are widely used to treat malignant gastric outlet obstruction (GOO). However, stent migration is a well-known complication. We report a rare case of small-bowel impaction caused by the migration of a duodenal SEMS with a biliary plastic stent (PS). A 78-year-old woman with pancreatic head cancer underwent biliary PS and duodenal SEMS placement for obstructive jaundice and GOO. At 4 months after initiating neoadjuvant chemotherapy, computed tomography revealed tumor shrinkage and improvement in duodenal stenosis; however, the SEMS and PS had migrated to the ileum. Double-balloon enteroscopy was attempted; however, stent removal was unsuccessful because of mechanical interlocking and impaction. Therefore, a partial ileal resection was performed. Histopathological examination revealed transmural infiltration of inflammatory cells and abscess formation. If a duodenal SEMS migrates with a biliary PS, mechanical interlocking may occur, resulting in small-bowel impaction. Clinicians should be aware of this rare complication and should consider careful follow-up and timely intervention if stent migration is detected. Trial Registration: N/A.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.