Find out more about the stents to relieve jaundice in advanced bile duct cancer (cholangiocarcinoma).
Bile duct cancer (cholangiocarcinoma) can block the bile duct. This causes jaundice, which can have the following effects:
- yellowing or darkening of the skin and whites of your eyes
- feeling sick
- darkened urine
- feeling weak and tired
Your doctor may suggest putting a tube called a stent into the bile duct. The stent allows the bile to flow into the bowel again and reduces the symptoms of jaundice. Having a stent put in is generally a simple procedure that you can have done with either a local anaesthetic or a medicine to make you feel drowsy (a sedative).
Stents can block after a few months and may need to be replaced. If the stent does not work for any reason, your specialist may suggest bypass surgery to relieve jaundice. Bypass surgery is quite a major operation.
If your doctor suggests major surgery, you may want to talk this over fully with your doctor and nurse. It may also be helpful to discuss it with your close family and friends. No one can say how much you will benefit from the surgery. It is likely to be quite a big operation. But you may make a good recovery and feel better for longer if you have it done.
Having a stent
A stent is a small plastic or metal tube put inside the bile duct or top of the small bowel (duodenum) to keep it open. Your nurse will ask you not to eat or drink for 6 hours before having a stent put in. Fasting means that your stomach and upper bowel will be empty.
You will not need a general anaesthetic. You can have a stent put in with just a sedative to relax you.
There are two ways of putting a stent in:
- using an endoscopy
- putting a stent in through the skin.
Stenting using endoscopy
Stenting using endoscopy means that the doctor puts a flexible tube called an endoscope into your mouth and passes it down your throat to your stomach. The tube has a camera on the end, so the doctor can see inside your body using an eye piece at the top of the tube or by watching a screen.
The doctor passes the endoscope tube all the way down through your stomach to the first part of the small bowel (the duodenum). They can then see the opening of your bile duct. Once the endoscope tube is in place, the doctor injects dye into the bile duct.
They use an X-ray to watch the flow of the dye and see where the duct is blocked. Once the doctor has found the blockage, they can stretch the duct and put the stent in place.
Putting a stent in through the skin
Putting a stent in through the skin is called percutaneous transhepatic cholangiography (PTC). You have a local anaesthetic to numb the area where the needle is to go in. The doctor uses dye to show up the bile duct and blockage. Then the doctor puts a needle attached to a wire through the skin. They move the needle carefully into position inside the bile duct.
The X-ray helps the doctor to see where to put the wire. Once the wire is in place, the doctor feeds the stent along the wire until it is in place inside the bile duct. Then the doctor pulls the wire out.
After having a stent
After a stent procedure, you will need to recover from the sedative. You may need to stay in hospital overnight.
You may need to take antibiotics for a few days afterwards, to prevent infection. You are at risk of infection while you have the stent in place. Bacteria from the gut can travel up the stent into the bile ducts or to the gall bladder.
If you have signs of infection at any time while the stent is in place, contact your doctor straight away. Signs of infection include a high temperature and shivering. You may need to go into hospital to have antibiotics through a drip.
A stent should keep the bile duct open. The stent stops bile from building up and causing jaundice. You should notice the benefit within a couple of days of having your stent put in. Unfortunately, stents can become blocked after a few months. If necessary, your stent can be replaced by the same method as before.