분할 췌장의 배측 췌관 근위부로 일탈된 스텐트의 미니 스네어를 이용한 내시경적 회수 1예
Endoscopic Retrieval of a Proximally Migrated Stent in the Dorsal Duct of Pancreas Divisum
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만성 췌장염에 동반된 주췌관 협착의 내시경 치료로 주췌관 내로 스텐트를 삽입할 수 있다. 스텐트 삽입에 의한 합병증의 하나로 스텐트의 일탈이 발생할 수 있는데, 췌관 근위부로 일탈되는 경우 일탈된 스텐트가 췌관 손상을 일으켜 심각한 합병증을 유발할 수 있다. 일탈된 스텐트는 내시경 시술을 이용하여 제거할 수 있으나, 담관에 비하여 상대적으로 직경이 작은 췌관의 경우에는 용이하지 않은 어려운 점이 있다. 저자들은 분할췌장에 의한 만성 췌장염 환자에서 통증 경감을 위해 배측 췌관에 삽입한 플라스틱 스텐트가 췌장 체부 및 미부로 일탈된 것을 확인하고, 미니 스네어를 이용하여 일탈된 스텐트를 성공적으로 회수하였기에 문헌고찰과 함께 보고한다.
Abstract
Endoscopic treatment of chronic pancreatitis by stent insertion is an accepted procedure, but various complications can be induced, including proximal migration of the stent. Many techniques are used to retrieve proximally migrated, pancreatic stents. We here report a case of a proximally migrated stent into the dorsal duct of a pancreas divisum, which was retrieved endoscopically by using a mini-snare. A 39-year-old female patient had chronic pancreatitis with divisum. A stent was inserted into the dorsal duct to relieve the chronic pain. After two months, sudden epigastric pain developed due to proximal migration of the stent. The pancreatic stent was retrieved successfully with one endoscopic attempt using a mini- snare. The epigastric pain resolved after retrieval of the stent. Our observation is that pancreatic stent migration may cause severe abdominal pain and that endoscopic retrieval is possible. (Korean J Gastrointest Endosc 2006;33:58-62)
참고문헌 (20)
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