Stent-in-stent through a side hole to prevent biliary metallicstent migration

Figure 1 Endoscopic retrograde cholangio­pancreatography after re-admission. A: Distal migration of self-expandable metallic stent (SEMS); B: 8-cm-long partially covered SEMS replacement; C: Retrieving the stent using a rat-toothed forceps after upward migration of SEMS.

Figure 2 Stent-in-stent thr­ough the side hole. A: Creat­ing a side hole at the distal end of the self-expandable me­tallic stent with argon plas­ma coagulation trimming; B: Insertion of plastic stent thr­ough the side hole; C: After the successful procedure for the prevention of stent migra­tion.