What is biliary stent placement?
A biliary (say "BILL-ee-air-ee") stent, also known as a bile duct stent, is a thin, hollow tube that is placed in the bile duct. The stent holds the duct open after the duct has been blocked or partly blocked.
Fluids like bile need to flow through your bile duct into your intestine to help digestion. If the duct is blocked, these fluids can build up in the liver. This can cause symptoms such as jaundice (yellowing of your skin and whites of your eyes), belly pain, and nausea. Bile that isn't draining as it should can get infected.
Opening up the duct with a stent allows bile to drain and can help you feel better.
There are two ways your doctor can place a bile duct stent: ERCP and PTC.
ERCP (endoscopic retrograde cholangiopancreatography)
In an ERCP, the doctor will use a tool called an endoscope, or scope. It is a thin, lighted tube that bends. It has a camera on it that lets the doctor use pictures on a screen to guide it. The doctor uses the scope to put a metal or plastic tube in the bile duct. This can help open the duct.
Before the test, you may get medicine to numb the back of your throat. You also will get medicine to help you relax.
PTC (percutaneous transhepatic cholangiography)
In a PTC, the doctor moves a long needle through your belly and into the liver. The needle is used to inject dye into the liver. X-rays are taken while the dye moves through the bile ducts. The doctor will take that needle out and insert a special hollow needle into the bile duct. The doctor will then move the stent through this needle and place it in the bile duct.
You will get medicine to numb your skin and keep you comfortable during the test. During the test, you will lie on your back. At some point you may be asked to roll to your side.
How do you prepare for the procedure?
Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.
Preparing for the procedure
- Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
- Understand exactly what procedure is planned, along with the risks, benefits, and other options.
- If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
- Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
- Make sure your doctor and the hospital have a copy of your advance directive. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.
What happens on the day of the procedure?
Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
Take off all jewelry and piercings. And take out contact lenses, if you wear them.
At the hospital or surgery center
Bring a picture ID.
You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
Tell your doctor if you are allergic to iodine. It is in the dye that the doctor puts into the bile ducts.
For an ERCP, the doctor may send puffs of air through the tube to see better. This may make you feel bloated.
You may feel some bloating or cramping as the ERCP tube is moved. If you are very uncomfortable, you can let the doctor know with a signal or a tap on the arm. You and your doctor can agree on this signal before the test.
After an ERCP, you will stay at the hospital or clinic for 1 to 2 hours until the numbing medicine wears off.
After a PTC, you will lie on your right side for about 6 hours. This is to lower the risk of bleeding from the injection site. After that, you can most likely go home.
When should you call your doctor?
- You have questions or concerns.
- You don't understand how to prepare for your procedure.
- You become ill before the procedure (such as fever, flu, or a cold).
- You need to reschedule or have changed your mind about having the procedure.
Where can you learn more?
Go to https://www.healthwise.net/patientEd
Enter S148 in the search box to learn more about "Biliary Stent Placement: Before Your Procedure".
Current as of: November 30, 2022
Author: Healthwise Staff
Medical Review:Adam Husney MD - Family Medicine & Kenneth Bark MD - General Surgery, Colon and Rectal Surgery