Stents to relieve symptoms of bile duct cancer

Bile duct cancer can grow and block your bile duct. A blocked bile duct can make your skin and the white of your eyes turn yellow. This is called jaundice. Jaundice can make you feel unwell.

Your doctor may suggest that you have a small tube called a stent put in your bile duct to keep it open. The stent is made of plastic or metal and it is flexible. Having a stent will help you feel better. 

Symptoms of a blocked bile duct

A blocked bile duct means bile can’t flow from your liver to your small bowel. Instead, the bile builds up in your body. This is what makes your skin and the white of your eyes turn yellow.

Jaundice can also make you:

• feel sick

• lose your appetite

• have dark urine

• have pale coloured poo (stools)

• feel itchy

When your doctor puts a stent in, the bile can flow into your small bowel again. You usually notice the benefit within a day or two of having it done.

Before having a stent

The hospital will tell you when to stop eating and drinking before the procedure. They will also tell you if there is anything else you need to do to prepare for it.

Your doctor usually gives you a drug that makes you sleepy and relaxed before the procedure. This is called sedation.

How you have a stent put in

Your doctor puts a stent in:

• during a type of endoscopy called endoscopic retrograde cholangio pancreatography (ERCP)
• through your skin during a percutaneous transhepatic cholangiogram (PTC) - this is a way of looking at your bile ducts using x-rays

How your doctor puts the stent in depends on which type of bile duct cancer you have. You don’t normally need a stent if the cancer is in the bile ducts in your liver (intrahepatic bile duct cancer).

You may have a plastic stent if you are going to have surgery to remove the cancer. The stent will be removed during the operation.

If you can’t have surgery, or the cancer has spread elsewhere in your body, (advanced cancer) you normally have a metal stent. This can stay in for longer and will help control the jaundice.

Having a stent during an ERCP

You usually have a stent put in during an ERCP if you have distal bile duct cancer.

Your doctor puts a flexible tube called an endoscope into your mouth and passes 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 (contrast medium) into the bile duct. They use x-rays to watch the contrast medium flow through the ducts. This lets them see where the blockage is. 

When they find it, they put a wire down the endoscope and past the blockage. They pass the stent over the wire into the bile duct. Your doctor can then remove the wire and the stent stays in the right place.

Having a stent during a PTC

You usually have a stent put in through your skin if you have perihilar bile duct cancer.

You have a local anaesthetic injection into your skin above your liver. This numbs the area. Your doctor puts a long thin needle through your skin and liver and into your bile ducts. You may feel a twinge when the needle goes into the liver or some discomfort around your right shoulder.

Your doctor uses ultrasound or x-rays to help them guide the needle into the right place. They inject some contrast medium into the bile ducts. You may have a warm sensation through your body. This is normal.

The contrast medium shows up on the x-rays so your doctor can see where the blockage is. When they find it, they put a wire down the needle into the bile duct. They use it to guide the stent into place. When the stent is in the right place, they remove the wire and the needle.

After having a stent put in

You need to recover from the sedation after the procedure.

Your nurse checks your blood pressure, pulse and temperature regularly, and makes sure you are comfortable. They will also tell you when you can start eating and drinking again. This is usually once you are fully awake and if you don’t feel sick. 

You might be able to go home the same day as the procedure. Sometimes you may need to stay in hospital overnight.

Your doctor may ask you to take antibiotics for a few days after having the stent put in. This is to help prevent an infection. 

Unfortunately, stents can become blocked after a few months. Your doctor might ask you to have some blood tests after you go home to check that the stent is working properly. 

If needed, your doctor can unblock or replace the stent in the same way as before.