How Long Can You Leave a Biliary Stent In?

A biliary stent is a tube surgically placed to keep the bile duct open.

A biliary stent is a plastic or metal tube inserted into a bile duct. Biliary stenting is a procedure that opens the obstructed bile duct. Obstructed bile duct leads to the accumulation of bile in the liver resulting in yellowing of the skin (jaundice), dark urine, light stools, itching, nausea and poor appetite. 

The following may cause bile duct obstruction:

• Pancreatic cancer
• Pancreatitis (inflammation of the pancreas)
• Gallstones
• Radiation therapy
• Injury to abdomen
• Cholangitis (inflammation of the bile ducts)

Insertion of a biliary stent should be avoided in patients with the following conditions:

• Bleeding disorder
• Ascites (accumulation of fluid in the liver)
• Uncooperative patients
• Patients intolerant to pain

Before the procedure

• Refrain from eating or drinking for at least six hours before the surgery to ensure that the stomach and the intestine remain devoid of food. 
• Inform the physician about your medical and medication history, especially an allergy to iodine.
• Stop taking the following medicines before the surgery:
  • Coumadin (warfarin)
  • Aspirin
  • Clopidogrel
  • Arthritis medications
• Antibiotics will be given before the surgery and continued afterward for several days.

During the procedure

• The stent might be placed a few days after the biliary drainage procedure. 
• Stent placement can be achieved simultaneously with an uncomplicated percutaneous transhepatic cholangiography surgery.
• An introducer sheath or a short plastic tube carrying the stent delivery system is passed into the biliary system using a stiff wire. 
• The stent delivery system is then passed along the wire, and the stent is placed. 
• Balloon dilation helps to achieve sufficient expansion.

After the procedure

• After the procedure, you will be monitored for signs of complications. 
• You need to lie on your right side for at least six hours to reduce the risk of bleeding. 
• To ensure the proper functioning of the stent, you will be frequently assessed for changes in stool or urine color, jaundice, itching and abnormal liver functions, which indicates a narrowing of the bile duct. 

A biliary stent needs replacement after three to six months to avoid inflammation of the bile ducts (Cholangitis). Biliary stents staying more than three years can result in serious repercussions, which can be managed by surgical intervention only. A stent that has been left in the biliary system hardens over time and can result in

• Foreign body reaction around the stent, resulting in biliary stones
• Stent blockage
• Pancreatitis
• Stent moving from its inserted position 

Hence, it is necessary to replace the stent in the stipulated time.

Occasionally, stents can cause discomfort when placed, which might disappear after a few days. However, the stent may sometimes result in inflammation of the pancreas (pancreatitis). This can result in back pain.