Characteristics of and risk factors for early migration of biliary plastic stents after stone removal with endoscopic retrograde cholangiopancreatography

Background and Aims: Biliary plastic stents often fall off prematurely or shift from the duodenal papilla can cause recurrent biliary tract infection or intestinal perforation. We aimed to investigate the incidence of and risk factors for early migration of biliary plastic stents after ERCP. Methods: The study population underwent ERCP for bile duct stone removal and placement of biliary plastic stents were analyzed from March 2018 to December 2022. Patient data was obtained through the electronic medical records. Results: A total of 836 patients (60.40±15.58 years, 511 males) were included. 105 patients showed early stent migration, of which 91 (10.9%) patients showed early stent shedding, and 14 (1.7%) patients showed displacement of stent. Multivariate logistic regression analysis showed that the risk of early stent migration was significantly higher in patients with a duodenal diverticula (OR = 2.367, P = 0.005), duodenal sphincter incision (OR = 3.638, P = 0.007), and longer stents (OR = 0.423, P ＜0.001). The Christmas tree plastic stent was significantly less prone to early migration than the conventional biliary plastic stent (OR = 2.654, P = 0.034). The risk of stent displacement significantly increased with the degree of balloon dilatation (OR = 2.708, P = 0.043) and with the presence of diverticula in the descending part of the duodenum (OR = 6.412, P = 0.002). Conclusion: Early stent migration often occurs after ERCP. Therefore, patients with risk factors for early stent migration should be followed up carefully.