Table 1. Clinical and procedural characteristics of patients with duodenal perforation attributable to biliary stent migration.

Patient, age (Years), Gender	Indication for ERCP	Pancreatobiliary Diagnosis	ERCP Findings	Pancreatobiliary Stents Used (Stent Diameter, Stent Length)	Time to Perforation Identification (Days Post-ERCP)	Location	Treatment of Perforation	Potential Risk Factors
#1, 58, female	Abdominal pain, biliary stent exchange	Post-cholecystectomy biliary stricture	Common hepatic duct stricture	10 Fr, 9 cm plastic biliary stent in right hepatic duct 10 Fr, 11 cm plastic biliary stent in left hepatic duct 1	19	Retroperitoneal	Stent removal Endoscopic clip (3) closure Percutaneous drain for retroperitoneal abscess	Chronic rheumatoid arthritis on immunosuppressive therapy (methotrexate, infliximab, prednisone); periampullary diverticulum
#2, 40, male	Jaundice, CT abnormality	Metastatic abdominal desmoplastic small round cell tumor with biliary obstruction	Common hepatic duct stricture	10 Fr, 15 cm plastic biliary stent in left hepatic duct, groomed 1 10 Fr, 12 cm plastic biliary stent in right hepatic duct	2	Peritoneal	Stent removal Nasoduodenal suction and bowel rest Percutaneous drain for abdominal abscess	History of radiation and ongoing chemotherapy with pazopanib; cancer
#3, 88, female	Jaundice	Pancreatic adenocarcinoma with biliary obstruction	Distal common bile duct stricture	10 mm, 6 cm uncovered metal biliary stent in common bile duct 10 mm, 4 cm uncovered metal biliary stent placed 11 months later, within interstices of first (migrated) stent due to tumor ingrowth 1	1	Peritoneal + Retroperitoneal	Nasogastric suction and bowel rest Venting gastrostomy	Elderly; cancer
#4, 86, female	Jaundice, CT abnormality	Cholangiocarcinoma	Common hepatic duct stricture	8.5 Fr, 15 cm plastic biliary stent in left hepatic duct 1 7 Fr, 15 cm plastic biliary stent in right hepatic duct	2	Retroperitoneal	Stent removal Endoscopic clip (3) closure	Elderly; cachexia with recent weight loss; cancer
#5, 71, female	Jaundice	Metastatic pancreatic cancer with biliary obstruction	Distal common bile duct stricture + right main intrahepatic stricture	7Fr, 12 cm plastic biliary stent in right hepatic duct 1	14	Not defined	Stent removal Endoscopic clip (2) closure	Elderly; cancer
#6, 48, male	Cholangitis	Necrotizing pancreatitis	Common bile duct stricture	10Fr, 12 cm plastic biliary stent in common hepatic duct 1 10Fr, 10 cm plastic biliary stent in common hepatic duct	7	Retroperitoneal	Laparotomy	Severe duodenal edema; 5-month hospitalization with critical illness
#7, 61, female	Jaundice	Primary sclerosing cholangitis	Multifocal intra and extrahepatic biliary strictures	7Fr, 18 cm plastic biliary stent in left intrahepatic duct 1 7Fr, 15 cm plastic biliary stent in right intrahepatic duct	70	Retroperitoneal	Stent removal Endoscopic clip (4) closure
#8, 90, male	Cholangitis	Cholangiocarcinoma	Left main intrahepatic bile duct stricture	7 Fr, 13-cm plastic biliary stent in left hepatic duct 1	46	Not Defined	Stent removal Endoscopic clip (2) closure	Elderly; cancer
#9, 56, male	Jaundice, MRCP abnormality	Metastatic cholangiocarcinoma	Bismuth IV hilar stricture	10 Fr, 18-cm plastic biliary stent in left intrahepatic duct 1 7 Fr, 15 cm plastic biliary stent in right intrahepatic duct	47	Retroperitoneal	Stent removal Over-the-scope clip (OTSC) balloon to sweep sludge/pus	Cancer; on chemotherapy
#10, 52, male	Jaundice	Cholangiocarcinoma	Bismuth IV hilar stricture	10 Fr, 15-cm plastic transpapillary biliary stent in left hepatic duct 7 Fr, 13-cm plastic transpapillary biliary stent in right anterior hepatic duct 1 7 Fr, 13-cm plastic biliary stent in right posterior hepatic duct	102	Not Defined	Stent removal Endoscopic clip (3) closure	Cancer; on chemotherapy; chronic alcoholic
#11, 88, male	Jaundice	Metastatic gallbladder cancer with biliary obstruction	Common hepatic duct stricture	10 Fr, 9-cm plastic transpapillary biliary stent in right intrahepatic duct 10 Fr, 15-cm plastic transpapillary biliary stent in left intrahepatic duct 1	101	Retroperitoneal	Stent removal Endoscopic clip (2) closure	Elderly; cancer; on chemotherapy

¹Biliary stent causing perforation (in bold)