Asian Journal of Case Reports in Surgery

Background: Retained biliary stents are a recognized complication of ERCP for choledocholithiasis, and prolonged indwelling can lead to stone formation, obstruction, and recurrent cholangitis requiring endoscopic or surgical management.

Aims: To document a rare case of stentolith formation arising from prolonged biliary stent retention and to highlight the importance of timely stent removal and patient follow-up in preventing life-threatening biliary complications.

Presentation of Case: A 59-year-old female presented with obstructive jaundice five years following ERCP and CBD stenting for choledocholithiasis. The retained stent had served as a nidus for stone formation, generating a stone-stent complex (stentolith). Two successive endoscopic retrieval attempts were unsuccessful. She subsequently underwent open CBD exploration with en bloc extraction of the stentolith and bilioenteric reconstruction via choledochoduodenostomy, with an uneventful postoperative course.

Discussion: Prolonged biliary stent retention initiates biofilm formation, bacterial colonisation, and de novo stone deposition around the endoprosthesis. Failure of endoscopic clearance necessitates surgical intervention. This case reinforces the critical need for scheduled stent removal protocols and systematic patient education regarding biliary endoprostheses.

Conclusion: A forgotten CBD stent may escalate a routine procedure into a complex surgical undertaking. Proactive communication of the risks of stent retention, meticulous procedural documentation, and adherence to scheduled follow-up are essential to avert stentolith formation and its associated morbidity.