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Stents to relieve symptoms in pancreatic cancer

Men and women discussing pancreatic cancer

This page has information on using stents to relieve symptoms caused by advanced pancreatic cancer. You can find the following information

 

A quick guide to what's on this page

Stents to relieve symptoms in advanced pancreatic cancer

Pancreatic cancer can sometimes block the bile duct or small bowel (duodenum), which can cause symptoms such as jaundice and sickness. Jaundice is where your skin and the whites of your eyes go yellow or darken. You may also have itching. To help relieve these symptoms, your doctor may suggest putting a tube, called a stent, into your bile duct or small bowel (duodenum) to keep the blockage open. This is generally a simple procedure that can be done with either a local anaesthetic or a sedative

There are not really very many side effects from having a stent. You may need to take antibiotics for a few days afterwards to prevent infection. Unfortunately, stents can become blocked after a few months. If necessary, your stent can be replaced by the same method as before.

If you are unable to have a stent, or the stent does not work for any reason, your doctor may suggest bypass surgery to relieve your symptoms. This is quite a major operation. You may want to talk this over fully with your doctor and nurse and also with your close family and friends. No one can say how much you will benefit from the operation. But you may make a good recovery and feel better for longer if you have the surgery.
 

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Ways of relieving jaundice

Pancreatic cancer can sometimes cause pressure on the bile duct and block it. This causes jaundice, which can cause

  • Yellowing or darkening of the skin and whites of your eyes
  • Feeling sick
  • Darkened urine
  • Itching
  • Lethargy and tiredness

Your doctor is most likely to 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 local anaesthetic or 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. This is quite a major operation.

If your doctor suggests major surgery, you may want to talk this over fully with your doctor and nurse as well as with your close family and friends. No one can say how much you will benefit from the operation. It is likely to be quite a big operation and just when you are feeling very low. But you may make a good recovery and feel better for longer if you do have the surgery. There is more information about this operation in the section on surgery to relieve symptoms of pancreatic cancer.

 

Ways to relieve a blocked bowel

Pancreatic cancer can also sometimes block the top of the small bowel (duodenum). This causes sickness as the blockage stops food and drink passing from the stomach into the bowel.

As above, one way of relieving symptoms is to have a stent put in to keep the duodenum open. This should give most people relief from vomiting, and so you may feel like eating again. However you may only manage a soft diet at first. Your doctor may put a stent into the bile duct at the same time as the duodenum to prevent the cancer blocking the bile duct as well and causing jaundice.

If you are unable to have a duodenal stent, your doctor may offer you surgery to bypass the blockage. There is information about surgery to bypass a blockage in your digestive system in this section. Instead of surgery, it is possible to have drug treatment to relieve a blockage in your digestive system.

 

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. There are two ways of having a stent put in - stenting using endoscopy and putting a stent in through the skin. The information below describes how a stent is placed into the bile duct.

For either of these procedures, your doctor will ask you not to eat or drink for six hours beforehand so that your stomach and upper bowel are empty. But you will not need a general anaesthetic. You can have these procedures with just a sedative, to relax you. 

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 doctor can see inside your body using the 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 your duodenum until it reaches the opening of your bile duct. Once it is in place, the doctor injects dye into the bile duct and uses 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 is sometimes called percutaneous transhepatic cholangiography. You have a local anaesthetic to numb the area where the needle is to go in. Dye is used to show up the bile duct and blockage. Then, the doctor puts a needle attached to a wire through the skin and moves it 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 can pull out the wire.

 

After having a stent

After a stent procedure, you will need to recover from the sedative. Your doctor may want you to stay in hospital overnight so the nurses can keep an eye on you while you recover.

There are not really very many side effects from having a stent put in. You may need to take antibiotics for a few days afterwards, to prevent any infection from developing. You are at risk of infection while you have the stent in place because bacteria from the gut can travel up the stent to the gallbladder. If you have signs of infection, such as a high temperature and shivering, at any time while the stent is in place you should contact your doctor straight away. You may need to go into hospital for antibiotic treatment.

A stent should keep the bile duct open and stop bile building up and causing jaundice. You should notice the benefit within a day or two 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.

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Updated: 18 December 2012