Dadang Makmun

1. Choledochoduodenal Fistula, 2. Migratory Plastic CBD Stent

Case 1. A 43-year-old woman patient came to our hospital with jaundice. The endoscopic retrograde cholangiopancreatography (ERCP) revealed a fistula between common bile duct and duodenum, multiple stones in common bile duct with distended gallbladder, and stricture in part of common bile duct. Patient underwent dilatation of the fistula using plastic stent at first then followed by second procedure using Self Expandable Metallic Stents (SEMS).Case 2. A 57 years old female was admitted with biliary pancreatitis. Previously the patient had an ERCP procedure 3 years ago. This procedure was plastic CBD stent insertion. We repeated ERCP to explore CBD and stent. During ERCP we did not find CBD stent around papilla of Vater. Then, we used fluoroscopy and we found that CBD stent went inside CBD. We failed to pull out that plastic CBD stent with balloon and Dormia basket. Because of worsening condition, we inserted a smaller plastic CBD stent than first stent (double stent). Patient's condition became better thereafter. One month later, we suggested to perform MRCP before surgery

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