Successful Removal of Proximally Migrated Biliary Stent in a Liver Transplant Patient by Single-Operator Digital Cholangioscopy

A 61-year-old woman underwent orthotopic liver transplant, with intraoperative plastic biliary stent placement, for nonalcoholic steatohepatitis–related cirrhosis. When she presented a month later for the stent removal, the stent was noted to have migrated proximally into the donor bile duct on x-ray and computed tomography imaging (Figure 1). Endoscopic retrograde cholangiopancreatography with multiple extraction techniques failed to retrieve the stent. A single-operator digital cholangioscope (SpyGlass, Boston Scientific, Marlborough, Massachusetts) was used to identify the stent in the donor bile duct (Figure 2), which was then successfully extracted with the help of mini biopsy forceps (SpyBite, Boston Scientific, Marlborough, Massachusetts; Figure 3 and Video 1)