Endoscopic retrieval of a proximally migrated pancreatic stent: variation of the lasso technique.

retrieve proximally migrated pancreatic stents [1,2]. The lasso technique involves inserting a guide wire through the lumen of the migrated stent followed by insertion of a partially opened polypectomy snare over the wire to grasp the stent [3]. We present the case of a 72-year-old woman with recurrent acute biliary pancreatitis, who underwent endoscopic retrograde cholangiopancreatography (ERCP) for biliary sphincterotomy due to high surgical risk. During the ERCP procedure, a flared pancreatic stent (diameter 5 Fr; length 5 cm) was placed. However, in spite of the stent, the patient developed pancreatitis. A computed tomography (CT) scan showed proximal migration of the pancreatic stent (●" Fig. 1), and another ERCP procedure was carried out to retrieve it. The pancreatic duct was deeply cannulatedwith a guide wire introduced alongside the stent. We then threaded the external end of thewire through a partially opened polypectomy snare (●" Fig. 2) and gently closed the snare and introduced it over the wire in the pancreatic duct until it reached the distal end of the stent (●" Fig. 3). At this point, we gently opened the snare (●" Fig. 4) and manipulated it until we had lassoed the stent. Endoscopic retrieval of a proximally migrated pancreatic stent: variation of the lasso technique