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Volume 4, Issue 6, Pages 266-268 (June 2019) Endoscopic removal of a migrated plastic stent from the peritoneal cavity after an EUS- guided gallbladder drainage procedure Mayu Nishiyama, MD, Shigeto Ishii, MD, Toshio Fujisawa, MD, PhD, Hiroaki Saito, MD, PhD, Hiroyuki Isayama, MD, PhD VideoGIE Volume 4, Issue 6, Pages 266-268 (June 2019) DOI: 10.1016/j.vgie.2019.03.008 Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Ultrasonographic view of the gallbladder showing debris accumulation. VideoGIE 2019 4, 266-268DOI: (10.1016/j.vgie.2019.03.008) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Drainage of the gallbladder using a double-pigtail stent and nasogallbladder catheter, and drainage of the bile duct using a double-flap stent. VideoGIE 2019 4, 266-268DOI: (10.1016/j.vgie.2019.03.008) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 Migration into the peritoneal cavity of the duodenal edge of a double-pigtail stent placed in the gallbladder, and continued leakage of bile juice into the peritoneal cavity. VideoGIE 2019 4, 266-268DOI: (10.1016/j.vgie.2019.03.008) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 Additional drainage from the gallbladder and peritoneal cavity. Drainage tubes were percutaneously inserted into the gallbladder and the peritoneal cavity. VideoGIE 2019 4, 266-268DOI: (10.1016/j.vgie.2019.03.008) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 5 Exchange of a nasobiliary catheter for a straight-type plastic stent: placement of a 7F stent in the gallbladder through the duodenal fistula (white arrow). VideoGIE 2019 4, 266-268DOI: (10.1016/j.vgie.2019.03.008) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 6 Removal of a migrated double-pigtail stent from the peritoneal cavity by grasping it and pulling it out through the fistula. VideoGIE 2019 4, 266-268DOI: (10.1016/j.vgie.2019.03.008) Copyright © 2019 American Society for Gastrointestinal Endoscopy Terms and Conditions