Bile Duct Cancer: Stent or Catheter Placement

In some cases of bile duct cancer, the cancer may block the bile duct. This can cause bile to build up and cause symptoms such as pain, or yellow eyes and skin (jaundice).

There are several ways to treat this problem. Your doctor may do one of the below:

  • Place a short, thin tube like a small straw called a stent into the duct. The stent will help keep the duct open and drain bile that builds up in the area. 

  • Insert a thin flexible tube (catheter) to let excess bile to drain out of the body.  

Placing a bile stent or catheter may be done to relieve jaundice before surgery. It may also be used for advanced cancer to help keep the bile duct open, or drain out bile if surgery is not an option.   

A stent or catheter may be inserted with or without a surgical procedure.

Stent placement using ERCP

This procedure is done by a gastrointestinal endoscopist. This is a doctor who specializes in gastrointestinal (GI) procedures. He or she places a stent inside the blocked bile duct. This tube is called an internal stent or endostent. The procedure to place it is called endoscopic retrograde cholangiopancreatography (ERCP).

During this procedure, your throat is numbed. The doctor inserts a flexible tube down your throat to your small intestine. This flexible tube carries the stent. The stent is then passed into your bile duct.

Stent or catheter placement using PTC

This procedure is done by an interventional radiologist. The doctor places a needle through your skin and into your liver to inject a special dye. He or she then takes an X-ray picture of your bile ducts. This procedure is called a percutaneous transhepatic cholangiogram (PTC). The radiologist uses X-rays to guide him or her in placing a catheter or stent. 

During this procedure, an area on the right side of your abdomen is numbed. Then the doctor inserts a thin needle through your skin and into your liver. Dye is sent through the needle into your bile duct. X-rays show any blockage in the network of bile ducts. The doctor then passes a small wire through the needle into the area of blockage. Then, he or she places a long thin tube called a stent over the wire and guides it into your bile duct to keep it open. Or the doctor places a catheter into the duct. This allows bile to drain out of the body and into a small bag.

Questions to ask your doctor

Here are some questions you may want to ask your doctor about these procedures:                                                  

  • If I need a stent or catheter, which procedure do you recommend for me?

  • What will happen if I don't have the stent or catheter put in? 

  • Do you recommend a plastic or mental stent?

  • Do I need surgery to place the stent or catheter?

  • Is the stent or catheter permanent or temporary?

  • What kind of treatment do I need after the stent or catheter is placed?

  • How will I feel after the stent or catheter placement?

  • How do I empty the catheter bag?

  • When can I get back to my normal activities?

  • Will the procedure affect my diet?

  • How long will the stent or catheter need to stay in place?

  • What kind of complications should I watch for?

  • What kind of follow-up care will I need after stent or catheter placement?

What to expect after stent placement

The stent or catheter may be removed if you have surgery to try to remove the cancer. Or it may be left in place if you are not able to have surgery. If you had catheter placement using PTC, you may have a bile collection bag secured to your abdomen. Stents may need to be replaced after a few months, or they may become blocked. This can lead to infections or other problems. Your doctor and nurse will tell you about any other things you may need to watch out for.