Percutaneous Biliary Stent Placement
If the common bile duct is blocked permanently and that blockage cannot be corrected with surgery or an endoscope, it can be treated with a long-term biliary drain or with an indwelling stent, which is a little metal device that keeps the narrowing open. Most patients prefer a stent to a tube, because it is completely on the inside and requires no maintenance.
After a discussion with the referring provider (usually and oncologist, hepatologist, or surgeon) a percutaneous biliary drain is placed. Then, usually on a later date, a wire is advanced through the drain into the biliary system and across the blockage. The drain is exchanged over the wire for the stent. The stent is released and expanded with a balloon. The wire can then be removed and/or a small drain can be replaced, which can be removed at a later date.
The procedure has a small risk of bleeding, infection, and damage to nearby organs. If possible, patients should refrain from eating and drinking for 6 hours prior to the procedure and will be given medications to help them relax (i.e. moderate sedation). The procedure can be performed on both inpatients and outpatients, who typically can return to their room/home after monitoring.