72-year-old’s forgotten bile duct stent migrates, turns into stone inside liver after 10 years

“The stent had migrated into the liver and essentially turned into a stone,” explained Dr Dipak Bhangale, consultant gastroenterologist and hepatologist at Kokilaben Hospital, who led her treatment

MUMBAI: In an extremely rare and medically complex case, a 72-year-old woman was found to have a biliary stent inside her liver that had calcified into a stone-like structure after being left in her body for over a decade. The forgotten stent, which had severely migrated and become encased in bile and calcium, posed a major removal challenge—one stent was successfully broken and extracted, while the other had to be pushed into the intestine.

72-year-old’s forgotten bile duct stent migrates, turns into stone inside liver after 10 years

A biliary stent is a small tube inserted into the bile duct to keep it open and ensure proper drainage of bile from the liver to the intestine, typically used to relieve blockages caused by stones, tumours or inflammation.

Nalini Devidas Sawaskar, a resident of Dombivli, began experiencing persistent abdominal pain and vomiting late last year. Initially believed to be gastrointestinal distress, imaging at Kokilaben Dhirubhai Ambani Hospital in Navi Mumbai revealed a startling discovery: two plastic stents placed in her bile duct over 10 years ago, one of which had calcified and lodged deep in her liver.

“I thought it was just a minor stomach issue. We had no idea something from ten years ago could return like this,” said Nalini, who received the stent procedure to relieve a bile duct blockage caused by a common bile duct (CBD) stone.

Due to other chronic conditions—hypertension, cardiac problems and arthritis—Nalini had missed follow-up visits and forgotten about the stent altogether. No subsequent doctors noted its presence either.

“The stent had migrated into the liver and essentially turned into a stone,” explained Dr Dipak Bhangale, consultant gastroenterologist and hepatologist at Kokilaben Hospital, who led her treatment. “It had been sitting there for more than a decade. Over time, bile salts and calcium accumulated around the stent, creating a calcified, stone-like mass embedded in the liver tissue.”

Forgotten biliary stents are known complications but are rarely seen to this extent. While plastic stents are typically meant to be removed or replaced within three to six months, prolonged neglect can cause them to degrade, break apart or act as a nidus for stone formation.

“The biggest challenge was removal,” said Dr Bhangale. “Traditional endoscopy had already failed at another centre, and open surgery posed significant risks due to the patient’s age and underlying heart condition.”

In April 2025, the team opted for laser-assisted cholangioscopy, a minimally invasive procedure that uses a specialised endoscope and laser fibre to access the bile duct directly. With this advanced technique, the first stent—heavily calcified and embedded—was broken down using laser energy and removed piece by piece. The second stent was dislodged from the bile duct, fragmented, and carefully pushed into the intestine to allow it to pass naturally. Laser therapy was used to break down the calcifications surrounding both stents, making their removal possible without open surgery. “It was like removing a stone wrapped around a brittle plastic piece,” Dr Bhangale added. “One wrong move and it could have broken into fragments we couldn’t retrieve. It required extreme care.”

After the procedure, a temporary stent was placed to ensure proper bile drainage. Nalini was discharged within five days and has since made a full recovery.

“I feel like I’ve been given a second life,” she said. “If we hadn’t come to this hospital, we would never have known what was wrong.”

According to Dr Amey Sonavane, consultant hepatologist at Apollo Hospital (not involved in the case), “This is quite a rare phenomenon. Plastic stents are safe when monitored, but if ignored, they can lead to rare complications like these. Patients must be clearly told about the removal timeline.”

He stressed the importance of patient education. “Pain, jaundice or fever years after a stent should not be dismissed as coincidence. A proper medical review is essential.”

Dr Bhangale concluded, “Implants are not meant to be forgotten. This case is being submitted for publication to raise awareness among clinicians about the risks of unmonitored devices. Regular follow-up is not optional—it’s life-saving.” He is now planning to publish the case in a medical journal considering its rareness.