What to Know About Stent Placement for Bile Duct Cancer
If cancer is blocking your bile duct, your doctor may place a thin tube called a stent into the bile duct. It helps keep the duct open and drain bile that builds up in the area. This helps prevent symptoms such as pain, or yellow eyes and skin, called jaundice.
Placing a bile stent may be a temporary measure to relieve jaundice before surgery. It may also be used for more advanced cancers to help keep the bile duct open if surgery is not an option.
A stent may be inserted with or without a surgical procedure.
Stent placement using ERCP
A doctor specializing in gastrointestinal (GI) procedures, called a gastrointestinal endoscopist, places a thin tube--similar to a small straw--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, the doctor inserts a flexible tube down your numbed throat to your small intestine, and from there the stent is passed into your bile duct.
Stent placement using PTC
A specialist, called an interventional radiologist, injects a special dye into your liver bile duct and 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 percutaneous transhepatic bile duct drain or stent (PTBD).
Here’s what happens during PTBD. An area on the right side of your abdomen is numbed. Then the doctor inserts a thin needle into your liver through your skin. Dye is placed through the needle into your bile duct. X-rays reveal the network of bile ducts and any blockage. The doctor 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. One end of the stent is in the bile duct, and the other drains bile into your small intestine or to a bag outside your body.
Questions to ask your doctor about stent placement
You may be overwhelmed with the information that you receive from your doctor. It is important to take the time to gather as much information as possible. To help deal with the medical information and remember all of your questions, it is helpful to bring a family member or close friend with you to doctor's appointments. Here are some questions you may want to ask your doctor about stent placement for bile duct cancer:
If I need a stent, which procedure do you recommend for me?
What will happen if I don't have the stent put in?
Do I need surgery to place the stent?
Is the stent permanent or temporary?
What kind of treatment do I need after the stent is placed?
How will I feel after the stent placement?
When can I get back to my normal activities?
Will the procedure affect my diet?
How long will the stent need to stay in place?
What kind of follow-up care will I need after stent placement?
What to expect after stent placement
The stent 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 stent placement using a percutaneous transhepatic cholangiogram (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.