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).
This problem can be treated in several ways. Your doctor may:
Place a short, thin plastic or metal tube, like a small straw, into the duct. This tube is called a stent. It helps keep the duct open to drain bile that builds up in the area.
Insert a thin flexible tube (catheter) to let excess bile to drain out of the body. One end of the catheter is put into the duct. The other end comes out of your body. This allows bile to drain into a small bag that sticks to your belly (abdomen)>
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 can be put in with or without a surgical procedure.
Stent placement using ERCP
This procedure is done by a doctor who specializes in gastrointestinal (GI) procedures. He or she puts the 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, you are given medicine (sedation) so you won't feel pain, and your throat is numbed. The doctor puts a flexible tube down your throat and into your small intestine. This tube is moved into the blocked bile duct. This flexible tube carries the stent. The stent is then slid through the tube and into your bile duct.
Stent or catheter placement using PTC
This procedure is done by an interventional radiologist. The doctor puts 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 these X-rays to guide the catheter or stent into the blocked duct.
During this procedure, an area on the right side of your belly (abdomen) is numbed. Then the doctor puts a long, 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 slides a long, thin tube called a stent over the wire and guides it into the blockage and into your bile duct to keep it open. A catheter that drains bile out of your body can also be put in this way.
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?
Who will put in the stent or catheter?
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?
What kind of problems 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.
May 05, 2018
ERCP (Endoscopic Retrograde Cholangio-Pancreatography) Patient Information from SAGES. Society of American Gastrointestinal and Endoscopic Surgeons.
Levy, Adam S, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS