P2743 - Bowel Obstruction due to Enteral and Hepatobiliary Stent Migration: A Systematic Review

Abdellatif Ismail, MD¹, Mohanad Awadalla, MD², Shaikhoon S. Mohammed, MD³, Khalid Aloum, MD⁴, Ayman Elawad, MD⁵, Mohammad Adam, MD, MSc⁶, Hazem Abosheaishaa, MD⁷, Monzer Abdalla, MD⁸, Khalid Ahmed, MD⁹, Natalie Wilson, MD¹⁰, Mohamed Abdallah, MD¹¹, Mohammad Bilal, MD¹², Prabhleen Chahal, MD^13
1University of Maryland Medical Center, Baltimore, MD; ²Beth Israel Deaconess Medical Center, Boston, MA; ³Emory Clinic/Emory Healthcare, Atlanta, GA; ⁴St. Barnabas Hospital, Bronx, NY; ⁵Massachusetts General Hospital, Boston, MA; ⁶University of Missouri - Kansas City School of Medicine, Kansas City, MO; ⁷Icahn School of Medicine at Mount Sinai, Queens, NY; ⁸Ascension Saint Francis Hospital, Evanston, IL; ⁹University of Pennsylvania, Philadelphia, PA; ¹⁰University of Minnesota, Minneapolis, MN; ¹¹Cleveland Clinic, Cleveland, OH; ¹²University of Minnesota and Minneapolis VA Health Care System, Minneapolis, MN; ¹³Cleveland Clinic Foundation, Cleveland, OH

Introduction: Enteral and hepatobiliary stents (gastrointestinal (GI) stents) are a useful tool in the armamentarium of endoscopists. Migration of these stents can happen with, most stents passing through the intestine without adverse events (AEs), however, bowel obstruction (BO) has been reported in a few cases. In this comprehensive review of the literature, we aim to explore BO following GI stent migration.

Methods: A comprehensive literature search was conducted in all databases through April 2024 for cases of BO caused by GI stent migration. The outcome of interest was small or large BO resulting from stent migration. We collected data on patient and procedural characteristics, as well as clinical outcomes. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to identify full-length articles in English language.

Results: Of 6253 articles on the initial search, 52 met the inclusion criteria. All studies were case reports/series except two prospective and one retrospective cohort studies. A total of 57 patients had BO due to GI stent migration. Median age was 70 years (IQR 58-80), and 52.6% were male. A total of 23 patients (40.3%) had a history of abdominal surgery, and 23 patients (40.3%) had a history of abdominal or pelvic cancer.

Migrated stents initially placed were biliary (n= 22, 38.6%), esophageal (n= 14, 24.5%), gastric (n=7, 12.3%), pancreatic (n=7, 12.3%), duodenal (n=6, 10.5%), and colonic (n=1, 1.7%).

In 7 patients (12.3%), the stents were lumen-apposing metal stents, and these were gastric (n=6, 10.5%), inserted for cysto-gastrostomy, and biliary (n=1, 1.7%). In 2 cases (3.5%), the stents were fixed by sutures at the time of insertion, while the rest of the studies did not have data about stent fixation. Further stent characteristics are summarized in Table 1. The median time from stent insertion to BO was 120 days (IQR 29-519). The most common location of BO was small bowel in 50 cases (87.7%).

Management was as follows: surgical 39 (68.4%), endoscopic 12 (21%), conservative 4 (7%), percutaneous retrieval 1 (1.7%), not mentioned 1 (1.7%).

The median hospital length of stay was 7.5 days (IQR 4-9.5). Mortality occurred in 3 cases (5%).

Discussion: BO is a rare AE following GI stent migration, but can lead to significant morbidity and subsequent interventions.


Disclosures:


Abdellatif Ismail, MD¹, Mohanad Awadalla, MD², Shaikhoon S. Mohammed, MD³, Khalid Aloum, MD⁴, Ayman Elawad, MD⁵, Mohammad Adam, MD, MSc⁶, Hazem Abosheaishaa, MD⁷, Monzer Abdalla, MD⁸, Khalid Ahmed, MD⁹, Natalie Wilson, MD¹⁰, Mohamed Abdallah, MD¹¹, Mohammad Bilal, MD¹², Prabhleen Chahal, MD¹³. P2743 - Bowel Obstruction due to Enteral and Hepatobiliary Stent Migration: A Systematic Review, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.