Stent for a blocked bile duct
Having a stent put in with an ERCP
A stent for a blocked bile duct is usually put in using a procedure called an Endoscopic Retrograde Cholangio-Pancreatography (ERCP). An ERCP uses a tube with a camera on the end which is passed down your throat.
Before the ERCP, tell your medical team about any medicines that you are taking, especially medicine to thin your blood (such as warfarin or clopidogrel) or for diabetes (such as metformin or insulin). Your medical team will tell you how to take these medicines before the ERCP.
You will be asked not to eat or drink for at least six hours before the ERCP – although you may be able to have small sips of water up to two hours before. This is to make sure that your stomach and duodenum are empty.
You will have a sedative before the stent is put in. This will make you sleepy and relaxed, but won’t send you to sleep.
The flexible tube with a camera and light on the end (an endoscope) is put into your mouth and passed down your throat into your stomach. The camera shows the inside of your body on a screen. The stent is put inside the bile duct using a small wire. When the stent is in the right place the wire is removed. The stent should unblock the bile duct, which should then drain normally.
The ERCP usually takes 30-40 minutes.
Having a stent put in through the skin (PTC)
Some people may not be able to have a stent put in with an ERCP. Instead, the stent is passed through the tummy wall and liver, and into the bile duct, using a thin needle. This is called a Percutaneous Transhepatic Cholangiogram (PTC). A PTC is often used if the blockage is high up in the bile duct, near the liver.
You will have a sedative to make you sleepy. You will also have injections of a local anaesthetic into your tummy area or lower chest. This will make it numb, so that you can’t feel anything.
The PTC needle is guided into the bile duct using x-ray pictures on a computer screen. Dye is injected into the needle so that the blockage shows up on the screen. A wire is put into the needle and used to guide the stent into position. An x-ray will then be taken of your bile duct to make sure that the stent is in the right place.
Diagram of a biliary stent
What happens afterwards?
After an ERCP you may have a blood test to check that the ERCP has not caused any problems such as inflammation of the pancreas. You will be told when you can drink and eat again (normally after four to six hours). You will be told who to contact if you have any problems after the ERCP.
You may be able to go home on the same day or the next day. If you are going home on the same day, you will need someone to collect you from the hospital and stay with you overnight. This is because the sedative can stay in your body for up to 24 hours. Don’t drive, use machinery or sign any legal documents for 24 hours.
If you have a PTC you will usually need to stay in hospital for a few days afterwards. There may be a drain left in the bile duct for a few days to help the bile to flow freely. This will be removed before you leave hospital.
You may be given antibiotics before and after an ERCP or PTC to prevent an infection of the bile duct (cholangitis).
Will I feel better?
It is normally easy to know if the stent is working. Any symptoms of jaundice usually improve in the first couple of days. It may take around two to three weeks for your jaundice to go completely and for you to feel better. Until the jaundice is completely gone you may still feel tired and not have much appetite.
Bilirubin is a substance found in bile, and jaundice develops when there’s a build-up of bilirubin in the blood. Levels of bilirubin are measured with blood tests called liver function tests. The level of bilirubin in your blood will affect how soon you may be able to start treatment such as chemotherapy or radiotherapy. Your hospital should give you blood test forms or a letter to take to your GP to have the blood tests after one week, two weeks and so on.
If you have any questions or worries about having a stent put into your bile duct, speak to your doctor or nurse. You can also speak to our specialist nurses on our free Support Line.
More information on stents
Updated February 2019
Review date February 2021