Bile duct cancer can grow and block your bile duct. This can cause a number of symptoms and make you feel unwell. Your doctor may suggest that you have a small tube (stent) put in to clear the blockage and help you feel better.
A stent is a small flexible plastic or metal tube. Doctors use stents to open up a blockage caused by the cancer. This helps to relieve symptoms caused by the blockage.
Symptoms of a blocked bile duct
A blocked bile duct causes a build up of
- yellowing or darkening of the skin and whites of your eyes
- feeling sick
- loss of appetite
- darkened urine
- pale coloured poo (stools)
- feeling weak and tired
Treating a blocked bile duct
Putting a stent into the bile duct means that bile can flow into the small bowel again. You usually notice the benefit within a day or two of having your stent put in.
You usually have a stent put in during a type of endoscopy called an ERCP. This stands for endoscopic retrograde cholangio pancreatography. In some cases, your doctor may put a stent in through your skin, using a long needle. This is called percutaneous transhepatic cholangiography (PTC).
You can't eat for 6 hours before having a stent put in. This is to make sure that your stomach and bowel are empty. You can usually drink water up to 2 hours beforehand.
You have the procedure in the x-ray department. It can take up to 2 hours.
You usually have a drug that makes you sleepy and relaxes you before the procedure. This is called a sedative.
Putting in a stent using endoscopy
You usually have a stent put in during an ERCP if you have a distal extrahepatic bile duct cancer.
Your doctor puts a flexible tube called an endoscope into your mouth and pass it down your throat to your stomach. The endoscope has a camera on the end of it. This means your doctor can see pictures of inside your body on a screen.
They pass the tube through your stomach and into the first part of your small bowel (duodenum). The bile duct opens into the duodenum.
To find the blockage, your doctor injects dye into the bile duct. They use x-rays to watch the flow of the dye to see where the blockage is. They then put the stent in position to open up the bile duct so that bile can flow again.
Putting a stent in through the skin
Stents can be put into your bile duct by going through your skin. This is called percutaneous transhepatic cholangiography (PTC). You usually have a stent put in through your skin if you have a perihilar bile duct cancer
You have a local anaesthetic injection into your skin above the liver to numb the area. Your doctor puts a long thin needle through the skin and liver, and into the bile ducts. You may feel a twinge when the needle goes into the liver or some discomfort around your right shoulder. They use ultrasound or x-rays to help guide the needle.
Your doctor injects some dye (contrast medium) into the bile ducts. You may have a warm sensation through your body. This is normal. The dye shows up on the x-rays, so the doctor can see where the blockage is. They put a wire down the needle into the bile duct and use it to guide the stent into place.
After having a stent put in
You need to recover from the sedative after the procedure. Your nurse checks your blood pressure, pulse and temperature, and makes sure you are comfortable. You might need to stay in hospital overnight.
Your nurse tells you when you can start eating and drinking again. This is usually once you are fully awake and you don’t feel sick.
You might need to take antibiotics for a few days afterwards to prevent infection.
You might also need blood tests after you go home.
Unfortunately, stents can become blocked after a few months. If needed, your doctor can unblock or replace the stent in the same way as before.