106 Stentolith As an Uncommon Complication of Loss to Follow Up After Endoscopic Biliary Stenting

Abstract Introduction Endoscopic biliary stenting is a common procedure, with indications from malignant obstruction to benign stone disease. We discuss patient who re-presented after endoscopic having been lost follow up, large ‘stentolith’ requiring open CBD exploration. Case Presentation A 56-year-old female presented in 2013 obstructive jaundice and 2-week history of abdominal pain. She was smoker, but otherwise had no past medical, surgical, or relevant family history. After initial workup, ERCP sphincterotomy pigtail stent placement performed interval laparoscopic cholecystectomy 2014. Post-operative up not arranged, the subsequently 2020 fatigue. MRCP confirmed proximal linear artefact. Open exploration facilitated removal stone-stent complex. Discussion Complications include cholangitis, occlusion migration [2]. Stenting for failed extraction considered temporary measure, exchange at three months (1). However, patients may be return non-specific symptoms. rare cause de novo formation gallstone calculus encasing stent, phenomenon termed “stentolith” [4]. Proposed pathophysiology through promotion bacterial proliferation by biofilm calcium bilirubinate precipitation [6]. Variation has described, plastic stents developing circumferential stones [12-25], due potential space between wall stent. Conclusions This highlights importance robust inter-disciplinary working; careful follows implementation mandatory registry all hospitals stented patients.