MUMBAI, May 25 -- 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. 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 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 two plastic stents in her bile duct, over 10 years old, one of which had calcified and lodged deep in her liver. "I thought it was just a minor stomach issue," said Nalini. Due to other chronic conditions-hypertension, cardiac problems and arthritis-Nalini had missed follow-up visits and forgotten about the stent. No subsequent doctors noted its 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. "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 but rarely seen to this extent. Plastic stents are typically to be removed or replaced in three to six months, but 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 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. 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, allowing them to be removed without open surgery. 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. 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. 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." 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."...