Abstract With widespread application of pancreatic stent in managing pancreatic diseases and preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis, incidence of stent-related complications such as proximal migration has substantially increased. This study aimed to provide strategic insights for retrieving proximally migrated pancreatic stents by analyzing a large endoscopy center experience and synthesizing novel techniques. A retrospective analysis was conducted over 10 years, including 43 cases of proximally migrated pancreatic stent among 32,537 ERCP procedures (2014–2024). Patient demographics, stent features, and procedure details were assessed. Literature on advanced retrieval techniques was reviewed. Most patients (67.4%) were asymptomatic; epigastric discomfort occurred in 32.6%. Endoscopic retrieval was successful in 81.4% of cases (35/43), with 58.1% (25/43) achieved using a single accessory. Median operation duration was 35 minutes (interquartile range 24–59). Pancreatic duct pre-dilation significantly shortened the procedure (31 ± 9 vs. 47 ± 13 minutes, P < 0.001). Stent migration duration showed no correlation with procedure difficulty (r = 0.131, P = 0.201). Eight cases (18.6%) met criteria for difficult-to-retrieve stents (DTRSs), mainly due to ductal tortuosity, strictures, or migration into branch pancreatic ducts. All procedures were completed without perioperative complications. Endoscopic retrieval is safe and effective for proximal pancreatic stent migration. Success optimization requires careful preoperative evaluation, ductal preparation, and adoption of advanced techniques for difficult cases. The DTRS concept provides a valuable framework for clinical decision-making when standard retrieval fails.
Fan et al. (Mon,) studied this question.