Biliary Stent Placement: Before Your Procedure

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 with a camera that the doctor moves gently down your throat, through your stomach, and into the bile duct. The doctor then places the stent into the bile duct.

Before the procedure, 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 uses a long needle to inject dye into the liver. With the help of X-rays, the dye shows the doctor where the bile duct blockage is. Then a special hollow needle is inserted. The doctor moves the stent through this needle to place it in the bile duct.

You will get medicine to numb your skin and keep you comfortable during the procedure.

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

• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• 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.
• If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.
• 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.
• 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.

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.

Endoscopic retrograde cholangiopancreatogram (ERCP)

• 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.

Percutaneous transhepatic cholangiography (PTC)

• After a PTC, you will lie on your right side for about 6 hours. This is to lower the risk of bleeding from the needle puncture 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.