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Stents to relieve symptoms

A stent is a small tube that your doctor might put into clear a blockage in your body. They are made of flexible plastic or metal. They aim to relieve symptoms that a blockage causes. The symptoms depend on where the blockage is in your body. 

Blocked bile duct

Pancreatic cancer can grow and block your bile duct. This can cause a build up of bile, causing jaundice. Symptoms of jaundice include:

  • yellowing or darkening of the skin or whites of your eyes
  • feeling sick
  • loss of appetite
  • darkened urine
  • pale coloured stools (poo)
  • itching
  • tiredness and lack of energy (lethargy) 

Treating a blocked bile duct

Putting a stent into the bile duct aims to clear the blockage. This means that bile can flow into the bowel. 

Having a stent put in is generally a simple procedure. There are different ways you may have it put in either during an endoscopy or through your skin.

For both procedures, you don't eat or drink for about six hours before you have the stent put in. This is to make sure that your stomach and upper bowel are empty. You have a drug that makes you sleepy and relaxes you before the procedure. This is called a sedative.

Your doctor puts a flexible tube called an endoscope into your mouth and they pass it down your throat to your stomach. The endoscope has a light and camera on the end. This means your doctor can see pictures of inside your body on a screen.

They pass the tube through your stomach to your duodenum (the first part of the small bowel). Your bile duct opens into the duodenum.

Your doctor then injects dye into the bile duct and uses an x-ray 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 again so that the bile can flow again.

Stents can be put into your bile duct by going through your skin. This is called percutaneous transhepatic cholangiography (PTC).  

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.

You need to recover from the sedative. You might need to stay in hospital overnight while you recover.

You might need to take antibiotics for a few days afterwards to prevent infection. You are at risk of an infection because bacteria from your gut can travel up the stent to the bile duct.

Contact your doctor straight away if you have any signs of an infection, such as a high temperature and shivering. You may need to go into hospital to have antibiotics through a drip

If your stent blocks

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.

Stents can become blocked after a few months. If necessary, your stent can be replaced by the same method.

If your stents don't work

Your specialist may suggest bypass surgery to relieve jaundice if the stent does not work. This is quite a major operation. You might 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.

You may make a good recovery and feel better for longer if you do have the surgery.

Blocked bowel

Pancreatic cancer can block the top of the small bowel (duodenum). You'll probably feel and be sick as the blockage stops food and drink passing from the stomach into the bowel.

Treating a blocked bowel

A stent might help to keep the duodenum open. This should give you relief from being sick, and so you might feel like eating again.

Your doctor may put a stent into the bile duct at the same time as the duodenum.

Most stents go into the top of the small bowel (duodenum) using endoscopy.

Before the procedure

You stop eating and drinking 6 hours before the procedure. You'll have some sedation to help you relax. 

During the procedure 

The endoscopy goes into your mouth and passes through your food pipe (oesophagus) and stomach, into your bowel. 

A very thin guide wire passes down the endoscope into the blockage. 

The endoscope is removed and the thin wire guides the stent into the blockage. The stent gradually expands and opens up the blockage. 

Afterwards 

When the sedation starts to wear off you can start drinking and eating normally. You might feel a little drowsy for upto 24 hours. 

You may have a little pain after the procedure but you can have painkillers. 

There might be a little bleeding, but this usually stops by itself. 

The stent may slip out of position, but this is rare. If this happens, or the stent becomes blocked, you may have another stent put in.

Bypass surgery

Your doctor may offer you surgery to bypass the blockage, if you cannot have a stent.

Medicines

Drugs called somatostatin or octreotide might help relieve symptoms. It works by reducing the amount of fluid that builds up in your stomach and digestive system. This helps to stop you being sick and can relieve bloating.

Last reviewed: 
10 Oct 2019
  • Guidelines for the management of patients with pancreatic cancer, periampullary and ampullary carcinomas
    British Society of Gastroenterology (BSG), 2005

  • Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

    M. Ducreux and others (2015)

    Annals of Oncology Volume 26 (Supplement 5): v56–v68

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