Biliary stenting





Definition

A biliary stent is a plastic or metal tube that is inserted into a bile duct to relieve narrowing of the duct (also called bile duct stricture).


Purpose

Biliary stenting is used to treat obstructions that occur in the bile ducts. Bile is a substance that helps to digest fats and is produced by the liver, secreted through the bile ducts, and stored in the gallbladder. It is released into the small intestine after a fat-containing meal has been eaten. The release of bile is controlled by a muscle called the sphincter of Oddi found at the junction of the bile ducts and the small intestine.

There are a number of conditions, malignant or benign, that can cause strictures of the bile duct. Pancreatic cancer is the most common malignant cause, followed by cancers of the gallbladder, bile duct, liver, and large intestine. Noncancerous causes of bile duct stricture include:

  • injury to the bile ducts during surgery for gallbladder removal (accounting for 80% of nonmalignant strictures)
  • pancreatitis (inflammation of the pancreas)
  • primary sclerosing cholangitis (an inflammation of the bile ducts that may cause pain, jaundice, itching, or other symptoms)
  • gallstones
  • radiation therapy
  • blunt trauma to the abdomen

Demographics

The overall incidence of bile duct stricture is not known. Approximately 0.2–0.5% of patients undergoing gallbladder surgery or other operations affecting the bile duct develop biliary stricture.


Description

A biliary stent is a thin, tube-like structure that is used to support a narrowed part of the bile duct and prevent the reformation of the stricture. Stents may be made of plastic or metal. The two most common methods that are used to place a biliary stent are endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC).


ERCP

ERCP is an imaging technique used to diagnose diseases of the pancreas, liver, gallbladder, and bile ducts that also has the advantage of being used as a therapeutic device. The endoscope (a thin, lighted, hollow tube attached to a viewing screen) is inserted into a patient's mouth, down the esophagus, through the stomach, and into the upper part of the small intestine, until it reaches the spot where the bile ducts empty. At this point a small tube called a cannula is inserted through the endoscope and used to inject a contrast dye into the ducts; the term retrograde refers to the backward direction of the dye. A series of x rays are then taken as the dye moves through the ducts.

If the x rays show that a biliary stricture exists, a stent may be placed into a duct to relieve the obstruction. In order to do this, special instruments are inserted into the endoscope and a sphincterotomy (a cut into the sphincter of Oddi) is performed to provide access to the bile ducts. In some cases, the biliary stricture may first be dilated (expanded) using a thin, flexible tube called a catheter, followed by a balloon-type device that is inflated. The stent is then inserted into the bile duct.


PTC

PTC is similar to ERCP in that the test is used to diagnose and treat obstructions affecting the flow of bile from the liver to the gastrointestinal tract. The procedure is generally reserved for patients who have undergone unsuccessful ERCP. A thin needle is used to inject a contrast dye through the skin and into the liver or gallbladder; x rays are taken while the dye moves through the bile ducts. If a biliary stricture becomes evident, a stent may then be placed. A hollow needle is introduced into the bile duct, and a thin guide wire inserted into the needle. The wire is guided to the area of obstruction; the stent is advanced over the wire and placed in the obstructed duct.


Diagnosis/Preparation

Prior to ERCP or PTC, the patient will be instructed to refrain from eating or drinking for at least six hours to ensure that the stomach and upper part of the intestine are free of food. The physician should be notified as to what medications the patient takes and if the patient has an allergy to iodine, which is found in the contrast dye. Antibiotics will be started prior to surgery and continued for several days afterward.


Aftercare

After the procedure, the patient is monitored for signs of complications. In the case of ERCP, the patient generally remains at the hospital or outpatient facility until the effects of the sedative wear off and to ensure no complications occur. After PTC, the patient is instructed to lie on his or her right side for at least six hours to reduce the risk of bleeding from the injection site. To ensure that the stent is functioning properly, the patient will be frequently assessed for symptoms that indicate the recurrence of biliary stricture. These symptoms include changes in stool or urine color, jaundice (yellowing of the skin), itching, and abnormal liver function tests .


Risks

Complications associated with ERCP include excessive bleeding, infection, pancreatitis, cholangitis (inflammation of the bile ducts), cholecystitis (inflammation of the gallbladder), and injury to the intestine. PTC may result in bleeding, infection of the injection site, sepsis (spread of infection to the blood), or leakage of the dye into the abdomen. Complications specific to the stent include migration (movement of the stent out of the area in which it was placed), occlusion (blockage), and intestinal perforation.


Normal results

In more than 90% of patients, the placement of a biliary stent relieves the obstruction and allows the bile duct to drain properly.


Morbidity and mortality rates

The rate of serious complications with ERCP is approximately 11%, and 5–10% with PTC. Stent occlusion occurs in up to 25% of patients, and stent migration in up to 6%. Recurrence of biliary stricture occurs in 15–45% of patients after an average time of four to nine years.


Alternatives

The major alternative to biliary stenting is surgical repair of the stricture. The most common method is resection (removal) of the narrowed area followed by the creation of a connection between the bile duct and the middle portion of the small intestine (called a choledochojejunostomy) or the hepatic duct and the small intestine (called a hepaticojejunostomy). Surgical stricture repair results in a cure for 85–98% of patients and is associated with a low risk of complications.


Resources

BOOKS

Feldman, Mark, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 7th ed. Philadelphia: Elsevier Science, 2002.

ORGANIZATIONS

American Gastroenterological Association. 7910 Woodmont Ave., 7th Floor, Bethesda, MD 20814. (301) 654–2055. http://www.gastro.org .

American Society for Gastrointestinal Endoscopy. 1520 Kensington Rd., Suite 202, Oak Brook, IL 60523. (630) 573–0600. http://www.asge.org .

Society of Interventional Radiology. 10201 Lee Highway, Suite 500, Fairfax, VA 22030. (800) 488–7284. http://www.sirweb.org .

OTHER

Pande, Hemant, Parviz Nikoomanesh, and Lawrence Cheskin. "Bile Duct Strictures." eMedicine. June 3, 2002 [cited May 1, 2003]. http://www.emedicine.com/med/topic3425.htm .

Yakshe, Paul. "Biliary Disease." eMedicine. March 29, 2002 [cited April 7, 2003]. http://www.emedicine.com/MED/topic225.htm .


Stephanie Dionne Sherk

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?


Biliary stenting is usually performed in the xray department of a hospital or outpatient facility in consultation with a general surgeon, a gastroenterologist (a medical doctor who specializes in the diagnosis and treatment of diseases of the digestive system), and/or an interventional radiologist (a medical doctor who specializes in the treatment of medical disorders using specialized imaging techniques).

QUESTIONS TO ASK THE DOCTOR


  • Why is biliary stenting recommended in my case?
  • What diagnostic tests will be performed prior to the stenting procedure?
  • What technique will be used to place the stent?
  • What type of stent will be used and how long should it last?
  • Is surgical repair of the stricture a better alternative?

User Contributions:

Flora Chishaka
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Jul 26, 2007 @ 3:03 am
Doctors are saying i have pancreatic cancer and yet wnen i went through their notes the results of a biospy done read:

Pancrease head - normal fine
tail - normal
What could it be, they said it has already spread and they cannot help me anymore. They said so surgery or chemotherapy can help and i should get peace with my relatives as i dont have long to live. This was done at a Hospital South Africa. I am Zimbabwean
Joyce Caldwell
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Feb 24, 2009 @ 6:18 pm
On 12/26/08 I had ERCP with a stint placed in my bile duct because of gallstones. On 12/30/08 I had my gallbladder removed and within 15 days went back to have the stint removed but it had moved into my intestines. I have been having weekly x-rays and the stint has not moved. I ask my family physician today (2/24/09) if this can cause infection or a blockage and he told me no. Ten years ago I had 4 surgeries and my intestines and colon have been restructered. This has complicated the viewing of the stint due to clamps in my intestine. Have you ever heard of a case like mine, and if so, what was the outcome?
bev
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Jul 7, 2009 @ 3:15 pm
I am a 69 year old female who was found to have ovarian cancer
40 yrs ago. Now they have discovered a small tumor that is pressing on my bile ducts also a type of ovarian cancer.

They want to put a stent in my bile duct, to help the slight
jaundice I have., and possibly treat me with chemo. What do you think.
Mumtaz Qureshi
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Jul 29, 2009 @ 3:03 am
My father (80 yrs old)diagnose with obstruction in bileduct.plastic stent was place through ERCP.After three month operation was perform and bile duct cancer was diagnose.Then in consultation with surgeon ,metalic stent was inserted and patient start recovering and become in good health which remain for about five months.Now again in his LFT test it is found that stent/bile duct is once again block.
Please what will be the next step.As doctor told us that metallic stent is last for life and would not block.Anyhow can this stent be reopen or new it require new stent or any other treatment will require??????
Luz Molina
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Aug 10, 2009 @ 9:09 am
bile topic ptc stenting, ercp and reason/ purpose of the procedure. read more on other reference.
Joanne
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Aug 23, 2009 @ 11:11 am
My dad, who is 74 years old, has been diagnosed to have intrahepatic cholengiocarcinoma mainly in segment 4 with extention to the segments 3 and 8, and infiltration of the right portal vein at the porta hepatis. It measures 6x7x7 cm. there is no regional lymphadenopathy, no ascites. this was done through CT Scan. He has also consulted the hepatic specialist and surgeon and they said there is nothing they can do for my dad. They said he can't be operated and there is no medication, not even chemotherapy. The surgeon did mention about the biliary stent but she said it's not necesary now as my dad has not develope jaundice. I will see the surgeon tomorrow to get back the results to seek second opinion. Can anyone help?We are in Malaysia
mary
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Oct 9, 2009 @ 2:14 pm
How long a stent last in a bile duct? and often have to be check after it is place?
Dennis
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Dec 23, 2009 @ 10:10 am
I had gall bladder surgery and a stent was placed in my liver at that time. How soon should the stent be removed and could there be any complications from it.
R Bokenfohr
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Jan 13, 2010 @ 4:16 pm
I had a stint put in on Monday and the pain is overwhelming. It feels like something is constantly moving in my upper stomach. Tryed eating some pudding and a toast and the pain after was awful. Is this normal
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Mar 1, 2010 @ 10:22 pm
I recently had my stints taken out of my bile duct, I had my gallbladder taken out 3yrs ago. I have been having alot of pain on my right side, migrains and alot of sharp pains behind my belly botton, should I be concerned.
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Jun 22, 2010 @ 2:14 pm
How long should a stent in the bile duct be kept in and should there be regular check ups.
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Jul 13, 2010 @ 8:08 am
TWO WEEKS AGO TODAY I HAD A BILIARY STENT PUT IN AS MY BILE DUCT KEPT BLOCKING AND I HAD MY GALL BLADDER REMOVED SEVERAL YEARS AGO I AM STILL IN CONSIDERABLE PAIN IN MY ABDOMEN AND WONDERED IF THIS IS NORMAL? I WOULD BE GRATEFUL IF YOU COULD ENLIGHTEN ME AS TO WHAT TO EXPECT THANKYOU
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Jul 14, 2010 @ 11:11 am
I had My gallbladder removed on 6-21-2010. the first 2 days were OK and then the 3rd day I went to er because of pain in my stomach. CAT scan was done and another imaging test. I was told I needed a stent put into the bile duct of my liver. on 6-25-2010 an ERCP was performed and There was almost an instant relief. Although when I eat I have a lot of pain. I feel burning at times, the sensation that I'm being punched from the inside, and I feel the food moving through my stomach. It's been almost 3 weeks. I've been told that the stent needs to be removed after at least 6 weeks. I was told the stent may be the cause of the pain and doctors want to wait and see if once removed, the pain goes away. Does that sound right?
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Jul 15, 2010 @ 1:13 pm
This article is very thorough in it's explanation on stents in ducts.
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Jul 28, 2010 @ 4:16 pm
I am 88 years old -= femal -and after two unsuccessfull ERCP's for the removal of a 9cm gallstone in my bileduct. This was removed at the third ERCP but in doing so my bowel was perforated. During that procedure a stent was put in my bile duct. After a five week stay in hospital following the occurrence during the third ERCP I am now supposed to have the stent removed. Last week the surgeon attempted to remove the stent - by another ERCP- but was unable to do so. I am concerned as to what will be the next procedure I understand it will require yet another ERCP but would like to know what the risks are in doing it or any alternatives. Accordimg to the surgeon the stent must be removed... Can you please advise-Many thanks
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Aug 21, 2010 @ 10:10 am
I recently had a ercp done, and woke up with a bile duct stint, and a pancreatic stint(plastic). My body was trying to reject them for the first 2 weeks. The pain (note while on narcotics for the pain), was unbearable, the contration(like someone was kicking me from the inside-right side-)where short lasting,but diabilitating. I missed 3 weeks of work, and after the 3 months, they are removing them. Is that what is normally done, and how do I know I won't get the narrowing of the ducts again? I hate the thought of going thru this hell!!
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Oct 1, 2010 @ 11:11 am
I, in the past week have had an Endoscopic procedure and a stint put in liver bile duct.
I am still having some abdominal pain ,eyes and skin still have the yellow tint.

My question is how long does it take for the pain and jaundice to go away?
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Oct 5, 2010 @ 6:18 pm
How long can a plastic stent stay in my bile duct?
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Oct 13, 2010 @ 9:21 pm
I recently had an ERCP. I had a stent placed in my common bile duct. I developed acute pancreatitiis and was in the hospital for 5 days. The pain and bloating was almost unbearable. I am now out of the hospital, but I have a lot of epigastric pain that feels like someone is squeezing my upper abdomen inside of their fist. It is worse when I eat anything (non fattening) and it feels like I need to belch or pass gas,but can't. How long will this last? It is very painful and I do not want to get addicted to the pain meds.
Benn
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Nov 1, 2010 @ 6:18 pm
WHEN SOMEONE HAS BILE DUCT OBSTRUCTION OR BLOCKAGE, DOES IT MEAN THEY HAVE CANCER? AN AFRICAN DOCTOR SAID SO AND THAT WAS NOT TRUE AT ALL ACCORDING ME BASED ON WHAT I KNOW, KINDLY ADVICE; AND BY THE WAY, I THOUGHT THE ONLY WAY A DOCTOR CAN TELL IF A PATIENT HAS CANCER IS ONLY BY PERFORMING BIOPSY TO THE INFECTED ORGAN OR PART OF THE BODY, AND NOT THROUGH IMAGING BECAUSE SOME IMAGES WOULD LOOK LIKE TUMOR BUT NOT CANCER AT ALL. KINDLY ADVICE
Kasia
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Nov 23, 2010 @ 3:15 pm
My mom had an ERCP on Friday where they made a cut and put a stent in her bile duct. She was left overnight at the hospital due to pain in her abdomen. She was released on Saturday because the pain went away somewhat. Since that shes still has been in pain. Theres times where she has no pain at all but there is times where it hurts pretty bad. She was supposed to have the stent removed tomorrow but after an xray was done it was shown the stent has moved. Today she also ( I think accidentaly) had an ultrasound. Before this she had no pain after the ultrasound and xray she had pretty bad pain. Two Tylenols helped but there is still dicomfort. It is normal for her to have pain like this?? How long will this last for?
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Dec 9, 2010 @ 12:00 am
My dad was diagnosed with obstruction in his bile duct (possibly cholangiocarcinoma) a couple of years back. He had his gall bladder removed back in 2002 and that probably caused it... we also came to know that he has Hepathitis C virus and a badly cirrhated liver.. Initially in January of 2009, they placed a plastic stent.. after a few months, it got blocked.. so they placed another one another april 2009.. it was good for another few months.. In november 09, they placed a metal stent.. he was ok for the most part until july after which he started having issues.. now we have in the hospital again and they are placing plastic stents again.. he's 68 years old now but he has been going down since the original problem was discovered.. Through out this 2 year period, he developed minor infections, jaundice, severe itching, a little pnemonia, mild tuberculosis etc... Though he's able to carry on with his life, it was not normal.. His sodium would drop down and he would not respond properly to us.. his ammonia would shoot up and he would look drowsy.. we are in India and I hope that they have given the right treatment..
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Jan 15, 2011 @ 5:17 pm
MY MOM HAD LAP CHOLECYSTECTOMY DONE 10 YRS BACK.LAST YEAR SHE HAD THOSE CLIP MIGRATED AND REMOVAL WITH STENTING DONE. NOW SHE HAS CBD STRICTURE FOR WHICH STENT HAS BEEN PLACED IN HER CBD.AGAIN SHE DEVELOPED STENT BLOCKAGE .DOCTOR SUGGEST METALIC STENTS IS IT ADVISABLE
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Jan 24, 2011 @ 11:11 am
my mother had a stint placed in her bile duct and was successful she is 87 years old now the doctor wants to remove it with possible placement of another one in the near future. this is very hard on her and do not want to put her through more procedures could we just let it be thank you
Christina
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Feb 2, 2011 @ 1:13 pm
I had my gallbladder removed on Jan. 12th and was still in pain so I went back to the doctors office where they set up a day that they would do an ERCP with possible stint placement in my bile duct. I had the ERCP with stint placement later that night at home I started having sever pain. I went to the ER where they said I had Pancreatitis. I stayed in the hospital 6 day and they sent me home. I was wondering when they go back in a few days to remove the stint what is the possibility that I will get Pancreatitis again. Also is it normal to break out in rash and still have abdominal pain after your levels return to normal. Also why after a week can I still not keep foods down.
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Feb 9, 2011 @ 11:11 am
My brother aged 40 is having metastatic adenocarcinoma in the celiac lymph node. is there any possibility to cure this condition? Pls reply.
Petrovic Vesna
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Feb 11, 2011 @ 3:15 pm
My dg is NET with sec. deposits in lung, liver, pancreas and kidneys. Because of obstructive icterus I had ERCP twice without succeed and I got an extra biliary catheter 3 months ago.They plan to redo a stent through mentioned catheter after 3 months of cytostatic therapy. Do you think they will go through catheter or from the mouth which they said it was impossible because of sec deposit. Much obliged, Vesna Petrovic
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Feb 19, 2011 @ 9:21 pm
I had sx for gallbladder removal on 2/15/11 then next day on 2/16/11 they removed stones from bile duct & put in stent.
I have been experiencing a lot of what seems like spasms in that area. (upper right quad) they don't last but a second, but they are very very intense pain. Pain meds do not touch it. Went back to hospital on emergency they said bloodwork & x-ray was ok. What could be causing these awful pains?
Serafin Mabanag
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Mar 29, 2011 @ 4:16 pm
I had a metal stent installed 6-15-10 for a dilated cbd with a dx of adenoca of the distal cbd. the stent was working as expected but now ihave been having pain in the right side of my midabdomen I dont have jaundice. what do you think i should do now?
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May 8, 2011 @ 11:11 am
my husband had a metal stent put in 3/23/11 by an interventional radiologist and we were told it could last for years before needing replacement and now his gastroenterologist is telling us it has to be removed in three months

He cannot tolerate general anesthesia due to lung problems - it is all so confusing - please help
AMBER
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Jul 8, 2011 @ 6:06 am
I had a stent put in last week because I had a bile leak after my gall bladder surgery. I felt great the first 2 days after the stent and then started having cramping in my stomach and later sharp, stabbing pains in my right abdomin. Like you, my levels were all normal. I just wondered what you found out, or if the pain went away. I feel like they have NO answers for me, just take more pain meds.
Thank you for your time.
Amber
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Jul 10, 2011 @ 9:21 pm
had a spinterectomy with ercp had continued pain and had a bilary stent placement and had been having more pain and feels like i had chest pain and am not sure if it is pain from the stent that is normal or it is radiating to chest is this normal? can the stent cause more issues they had placed is because i have spincter of oddi
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Jul 22, 2011 @ 7:19 pm
On 6/24/11 i haqd a stent put in my common bile duct. I had many operations in the past. Now i am having issues/ swelling/pain/cannot eat or drink, without having alot of pain. Now my gastrolist tells me thats normal, but they want to remove the stent after one month. Does anyone out there know anyone with these same issues? If yes can you please help me, i am so afaird.
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Aug 10, 2011 @ 10:10 am
My father has undergone ERCP on 17th July 2011 and though his liver parameters are normal by and large he is still getting fever on and off. What could be the cause. Please advise by e-mail Thanks
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Aug 24, 2011 @ 1:01 am
Sir,
with the diagnostics i am having Hepatities B Jaundice, in MRCP TEST Mid CBD stricture and gal bladdar stone. In MRCP informed no blockage . doctor suggested for ERCP.
Please advise me for next course of action.
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Sep 24, 2011 @ 11:23 pm
I had this procedure done over 2 years ago. I think I may need this procedure again because I am getting this full feeling in my stomach when I eat food even if it is a little bit. So will make contact with my surgeon and arrange another appointment. I felt good after the procedure and it was much better than the medications that I was on. Has anyone else had the same procedure.
arpit
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Oct 1, 2011 @ 2:02 am
My father undergone ERCP on 26th sept. 2011.two days before the ERCP a stent was placed in his bile duct.Now the pain is still on after 6 days of ERCP .The X ray report says that the stent is at right position.What could br the reason for the pain? How long will it take to go? does he need to remove the stent to get relieve from pain?
please reply as soon as possible.
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Oct 15, 2011 @ 3:03 am
I am suffering CBD stricture and gal bladdar stone do external operation and remove gal bladder since last 8years,every six mouth or yearly from last 10 years biliary stenting changing,,my question is treatment do for permanent. or every time biliary changing from last 10 years. please give advice for needful suggetion.

above this i am suffering,DIABITIC,HYPERTENTION,JUNDICE.
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Oct 31, 2011 @ 10:10 am
By having a stint in did you loss your taste buds and how do you get them back? I want too eat something that taste like food not salt/ ickey. I only went in for a simple surg too remove my gallbladder and after a month in the hosp im no better now at all I want too know what too me.
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Nov 4, 2011 @ 12:00 am
Im 24 yrs old.I had my ERCP for CBD stone removal and a 5 cm stent was been placed on 7.09.2011.my gall bladder was been removed due to gall stone on 30th sep.i was been told to remove the stent on 2nd no.When the procedure for stent removal was going i was said that the stent is not seen and it could have been moved out through motion.Is this possible?Will i have any complications in future
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Nov 18, 2011 @ 7:07 am
Its almost a year now and my stent it still with me, any complication?
sumeet kamal
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Dec 12, 2011 @ 3:15 pm
my father,65yrs is suffering from obstructive jaundice (CBD STRICTURE,cancer).stent has been put at that portion.after 3 months :jaundice is cured but sometimes he is suffering from stomachache, gas,constipetion,low bloodpressure.local doctor has prescribed him pan 40,drotin,festal N,horlicks,Eva Q,elixir neogadine,ursodil 300, but still is restless due to pain.now what should i do.which diet should i give please suggest
don
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Dec 20, 2011 @ 6:18 pm
I am 51yrs old. Went in for laparascopic gallbladder removal Nov 4th. Biliary duct was torn during this procedure so open surgery ensued to finish removal of GB and repair of the duct. I am healing up OK, t-tube was removed on Nov 28th. Today I had imaging done for biliary duct. Doctor says there is still swelling at the site and the duct is still leaking a little where tube was removed. He says not to be concerned about leakage but the narrowing of the biliary duct may be a problem. I feel fine, not at all sick or jaundiced like before the removal. He says I could wait for a few weeks and do more imaging to see if the condition has improved (or) go see a gastroenterologist for further evaluation. Not sure what to do, is there any danger in waiting. Sounds like there are lots of risks having these stints placed w/ERCP.
Denise
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Jan 19, 2012 @ 8:20 pm
I had an ERCP procedure on Nov 16,2011,after having severe pain for 1 1/2 years..This was the second ERCP that I have had..The first one was 4 years ago and they had discovered that I have Pancreas Divisium and now have Chronic Pancreatitis,but it is not from alcohol,since I don't drink..The second ERCP,I had 3 extra large stints put in my biliary duct because of blockage.I have been having very severe and dibilatating pain since the surgery,and had to go to our local ER..They did xrays and the result was that my body is rejecting the stints.Now I was told by the Dr.that I have to have the stints removed asap..I am afraid that I have some major damage done,because I have been on very strong medication for almost 3 months..I am worried that I have Cancer and I am scared..It sounds like stints are either metal or plastic,What if there is infection because of this..Can someone tell me if this is normal?
Stones with no gallbladder
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Feb 24, 2012 @ 2:14 pm
I had my gallbladder removed Jan 2011.I had alot of pain like i had stones in march 2011.An ERCP was done Several stones were found.Again in June severe pain followed by an ERCP several more stones were found.Fast forward Feb 2012 severe pain again, another ERCP several stones again. This time the doctor put a stent in the bile duct 3 days later just had another less severe stone attack.Where are these stones coming from? One surgery and 3 ERCPs later and atleast one more to remove the stent.Any advice because my doctor seems to have none.
Charlotte
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Apr 16, 2012 @ 9:09 am
I would be interested in knowing what type of anesthesia is ususally used for performance of ERCP on an adult patient. How effective is it. Doers the patient need t be awake to gag on the endoscope tube and to feel the procedures being performed in the abdomen?
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May 15, 2012 @ 4:04 am
Missing Stent.
I recently had an ERCP. I had a stent placed in my common bile duct during last year Christmas Eve and was told by the doctor to return to remove it on 29 January 2012 but I start feeling pain on New Eve and was admitted but the doctor told me the pain is not due to the stent is should be the food I ate and I was discharge. Subsequently I was admitted again on 22 January 2012 due serious abdominal pain. This time the doctor discover that the stent had given way and they need to do the CT scan, x ray & ultra sound to find it. The doctor that perform the ERCP on 25 January 2012 manage to take out the stone from my liver but he told me he can't reach out for the stent and I was told by him that he may have to cut me to take it out. On 26 January 2012 4am they send me to take a x ray to confirm the stent where about but can't find the stent and the doctor told that the stent would have pass out. I'm ready concern can the stent be pass out?
ladonna
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Jul 31, 2012 @ 7:07 am
my son is only 23 and has 2 stints put in within 6 months he still hurting and where his liver is it feels hard as a rock,i really need to talk to someone who is going through the same thing maybe they can tell me things to help my son,ive been to a few docters and there dumb to this,they cant tell me whats going on and they cant direct me in the way to go,im confused and im cried out,
Adnan Ahmed
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Aug 6, 2012 @ 6:18 pm
My father has bile duct cancer and has had a stent put in about 6 months ago, recently he has been in alot of pain and also has constipation... Is there any connections between the two?
Also us there anyone who has had a similar experience...
Any help would be appreciated...
Susan
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Aug 15, 2012 @ 4:16 pm
I had my gall bladder removed 7/23/12. Stayed in hospital two days after surgery. After getting home I started feeling better. Four days after coming home I started running a high fever and was sick on my stomach. Went back to er and found out that my bile duct was leaking so had to have a t-tube put in which was very painful. The next day they put a stent in and told me I had to have it removed in 8 weeks. I dont have insurance and they need a good amount of money before they will remove it and I just dont have that kind of money. I was just wondering if it will hurt me if I dont have it removed? Thank You!
Jason
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Aug 16, 2012 @ 8:20 pm
In 2009, I started getting very sharp abdominal pain and it became severe after eating. I would vommit after every meal, and still do to this day. I was in terrible pain, and it went all the way through the middle of my back. I had several scopes done, and then in December of 2009, they did a E.R.C.P. A mass was found on my pancreatic duct, and a stent put in. The pain didn't get better, but worse. I had gone from 200lbs, down to 120lbs in a matter of a month. They did another ERCP and a pain block on the nerves from my pancreas. Again, my duct was blocked and a secon stent placed in the pancreatic duct. Again, this did not help at all. After a ultra sound on my gallbladder and liver, they said my gallbladder had failed, and my liver was in a shape they had never seen before. They also put in a feading tube, but I was allergic to the formula. The area around the tube became infected, and removed. This is all in the matter of 6 months. My family doctor tried to get me in to the Mayo clinic, but my insurance didnt cover that. I tried to fight through the pain, and return to work in Janruary of 2011, but after 3 hours, was in so much pain that I had to go to the ER. I was admitted for 14 days on heavy pain medication, and a pik line put in my arm so they could get me nutrition. The pik line actuall caused fat to build up in my blood, and they quickly removed it, and discharged me with no instructions. I lost my job, and insurance in February of 2011, and just recently went to a free clinic for help. I have been told numerous times that it sounded like pancreatic cancer, but they can't find it. Anyone else been through this or currently going through this? I'm ready to kill myself because of the pain.
Lee
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Sep 29, 2012 @ 2:14 pm
Had ERCP in 2011, stone removed, stent fitted. Cholecsytectomy in March 2012. June 2012, suffered cholangitis, had 2nd ERCP, more stones and old stent removed, wire cannulation of CBD. Concluded ERCP before completion due to discomfort and intolerance of procedure. 3rd ERCP in September 2012, removed 7 stones. 2 days later, passed wire CBD stent in stool.

Presumably it was felt I needed this stent, so guessing a replacement will be suggested via a 4th ERCP. Should I request surgical correction? After all, knowing that I passed 1 stent, what would prevent it happening again?
martha
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Oct 2, 2012 @ 12:12 pm
I am a 50 year old woman,this year alone I have had 5 ERCP's done. A partner working with my gastro doctor put in a plastic stent in my main bile duct but pushed it too far in,so the next ERCP a metal stent was put in,then taken out.With the 2 other ERCP's I ended up with pancreatitis,I also had sludge formation,despite having had my Gallblader removed almost 2 years ago.After another ERCP,stones,sludge,& a bezoar was found plus another metal stent was put in.Before the final ERCP was done in June,I told my doctor that I wanted the metal stent out then he told me it is embedded in my main bile doctor.I am livid at this point.Metal stents are mainly used for benign or malignant tumors.I also have pyloric stenosis,but nothing has been tried to stop that from happening. I was never told the metal stents were going to be used,nor was I ever told what was found with ERCP.I am now seeing a surgeon to find out what can be done,due to GERD and ulcers,and to hopefully fix the mess that has been done.Unfortunately with the metal stent that limits what type of surgery can be done.All come with a risk.I have been told the problems I have will shorten my life.I also have chronic pain in RUQ as well in my stomach.All I want is to have my surgeon find out what will be the best fix,because he's not sure what to do for me.
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Oct 19, 2012 @ 6:06 am
I am 54 i had an Mri scan which showed that i had 6 gallstones in my bile duct after suffering
a whole week of unbearable pain and vomiting after food i ate,i had the op they took the stones out
and put a stent in the duct to stop more stone going in I have to go back to have my gallbladder out
within the next 3 months and then 2 weeks after i have to go back in to have another op to
remove the stent from my bile duck but my question is should i still have discomfort pain in the tummy
and how long will it last for ? I had this done 2 days ago i came home with no pain killers or antibiotics
but was told i nnly get them if i was actually cut inside and what pain killers would u suggest to take ?
Thankyou
glenn
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Nov 12, 2012 @ 12:12 pm
My Mother is 90 years old had a blockage in bile duct - a stent was put in on 10-24-12. She is not doing good after the procedure but was told she would have to return to the hospital on 12-14-12 to have the stent removed. My question is: is it necessary to remove the stent? Her family does not think she can live through another procedure. She is worried so much about it she can not recover from the first procedure. Thanks in advance for your answer.
mjane55
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Dec 1, 2012 @ 10:10 am
How much pain should there be after having CBD stone removed and stent put in place. Feels like spasms. Is this normal?
Paritosh saha
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Jan 1, 2013 @ 6:06 am
1.After Biliary stenting the stent which we placed at CBD,can we leave it for life long..??
2.During stenting how stones are remove..??

Paritosh Saha
B.A.M.S Student
Crystal
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Jan 3, 2013 @ 4:16 pm
Gallbladder surgery in Dec 2011 during surgery Common Bile Duct was accidentally cut which cause me to go into septic shock and caused some organs to start shutting down... Had to have 2 Bilary tubes installed (which was horrible) however, they were removed about 3 months later. To make a story short; scar tissue caused my bile duct to narrow to where the bile could not flow through properly causing me to turn yellow; was admitted to hospital due to Bilirubin being at 9.9, surgeons advised ANOTHER tube would be necessary. Tube was done (again horrible) and a drainage bag was applied to the tube for some of the bile to drain from... I was wondering 1) how long is the tubes normally required 2) can this tube cause a huge decrease in energy/appetite 3) what are the percentage rates of these tubes being successful (to avoid surgery). Thank you for your time and attention, I look forward to hearing from someone.
peter murphy
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Feb 12, 2013 @ 2:14 pm
my mother 77 years old had her gall bladder removed six months ago. there were complications and had to have a stent put into the bile duct ,she has been fine since but now has to go back for the stent to be removed.
why can't the stent remain in if there's no problem.
margaret
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Feb 20, 2013 @ 3:03 am
All stents have to be removed within 8 weeks. Im not sure why patients are not being avisd about the stents. If plastic stents are not removed and replaced with new ones you can get hepatitis.. Metal stents should only be usd for cancer patients.
sally
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Mar 1, 2013 @ 5:05 am
i had my gaulbladder taken out last year,i had no gaul stones but was in severe pain i was in and out of hospital they should have never let me come home.I had a stent put in and after being drained of bile,which i was very ill i have been through it.I am going into hospital again next week as am having stent taken out,am not looking forward to this at all i know any type of surgery is risky but what i have been through i do worry so.We have raised many questions about what happened to me,i should have never been sent home and had scans much earlier than i did,maybe then i wouldnt have had to spend two weeks in hospital it all comes down to money i just hope i get sorted and will be alright.
Wayne Titus
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Mar 18, 2013 @ 8:20 pm
My mother has pancreatic cancer.She has jaundice.Would a stent help this ?
June
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Apr 25, 2013 @ 11:11 am
Mum is 82 and has just had a pigtail catheter placed in CBD.should she still have pain 3 days on?
Rose Ann Nuesse
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May 20, 2013 @ 8:20 pm
I am 68 had a stent put in by a Dr. Who did not know what he was doing. He put In a Metallic stent for a terminally ill cancer patient. Which I am not. I had a 4MM gallstone in billary duct.. I have hurt from day one and it is getting worse. Have persued a Dr who is Chief of staff of a well known hospital. That's how I found out it was for a cancer patient so it is not suppose to come out because they usually die than there is know need to take them out. I'm now starting to have back pains.. I just wonder if other people have had this problem and what have they done?
Rose Ann Nuesse
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May 20, 2013 @ 8:20 pm
I just read that plastic stents must be out in 8 weeks and any kind of metal stents or for cancer patient only.
Avery
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Jun 5, 2013 @ 2:02 am
62 year old female visited emergency with severe uncontrollable itching and jaundice. Prior two weeks; mild vomiting, slight headache, loss of weight, fatigue and unbearable itching. Doctor did blood test, bilirubin at 14.6. CT scan and ultra sound showed 6 cm mass in tumor pressing against bile ducts. Stent inserted and bile began to drain. Iodine scan of lower extremities. Patient to undergo cat scan guided needle biopsy. Patient is in abdominal pain, especially after eating and also sitting up. Hopeful that pain will stop soon. May be because of stent recently inserted. Will keep you posted with outcome. Prayers are with you all. Write to me!
Bob
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Jul 8, 2013 @ 11:11 am
I had a plastic biliary stent placed in my hepatic duct to my duodenum.June 14. Two weeks later the stent was evacuated in my stool. Is this the normal way that stints are removed from the body?
grace howard
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Jul 21, 2013 @ 7:19 pm
I, in the past week have had an Endoscopic procedure and a stint put in liver bile duct.
I am still having some abdominal pain ,eyes and skin still have the yellow tint.

My question is how long does it take for the pain and jaundice to go away?
rebecca
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Aug 10, 2013 @ 4:16 pm
i am a 51 year old woman. had gallbladder removed 5 years ago- after one week i felt good. then sever pain and vomiting of bile sent me to the hospital- i has slight elevation of liver enzymes, had ERCP which showed bile duct was very dialated. had stent put in, sphincter of oddi repair. over about a year after could still hardly eat without lots of pain as well as spasms of my bile duct. finally this subsided and my eating returned to fairly normal. since this, ive had a few episodes where i have gotten this same pain, vomiting of gallons of bile- but so far all of my blood tests look normal, yet, i am SO SICK! i wish my bllod test would show the elevations needed to do another ERCP- as maybe then they could correctly diagnose my problem. doc says possible pancreatic or bile duct scarring down, but says he cannott go in for the ERCP until the blood tests support it. my body has never been quick to show whats going on with lab tests- in the measntime...im so sick - and i need help. has anyone ever had similar experiences with slow showing lab tests? please reply- thank you.
sue
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Aug 20, 2013 @ 11:11 am
my husbsnd had a stent put in so gallstones could pass through. how long can this stint stay in the stomach?
Renate
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Sep 4, 2013 @ 8:20 pm
I have had two liver transplants. After the second I developed a biliary stricture. It was dilated via ballooning and PTC. 4 years later I was having bouts of cholangitis again so they reballooned. After less than a year, cholangitis is back. It makes me so sick but they are not willing to put in a stent and was wondering if anyone knows why. I think a stent is the obvious solution at this point. I'm only 30 and feel like I have no life- I can't make plans in case I suddenly get sick etc...
vi
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Oct 20, 2013 @ 12:12 pm
I have had five ERCP's. On the fifth a stent was inserted.

The doctors are now saying that ai should have my bile duct rerouted to my small intestine, surgically.

Is this the wisest thing to do? I have no gallblader.

Since having the stent put in I have frequent diahrhea.

I am a 74 year old female who was in good health prior to this.
Shahid Uddin Ahmed Shams
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Oct 27, 2013 @ 7:07 am
How long a biliary stent can be left without removal or how soon it should be taken out?
Peter
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Jan 10, 2014 @ 4:04 am
How long a stent last in a bile duct? or how soon it should be taken out.
mim
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Mar 1, 2014 @ 7:19 pm
how long can metal biliary stents stay in the common bile duct?
how long can the plastic biliary stents stay in the common bile duct?
Chris
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Mar 4, 2014 @ 8:20 pm
Had gallbladder removed; was informed there was a extra flap connecting to my gallbladder that was not removed when it was taken out; therefor it punctured, and caused a bile leak. After the worst pain of my life, a ERCP was mentioned; however due to airway complications it could not be preformed. A minor procedure was done (which was aweful) to insert tubing that connected to an external drain bag to collect the bile. I wore it/cleaned it for a few weeks; then had the external bag removed but, the port and internal tubing remains. I am set to have a PTC at the end of the month and do not know what to expect pain wise. Has anyone had a similar experience? I can not be sedated for any of it, as I had my gallbladder out; and they have informed me you can't give to much anesthesia in short periods of time. I will need to be awake with a local anesthesia which is what they did when they placed the tubing. They said it would be a little uncomftorable. At that time, due to damage of the bile leaking through my body; I was on a morphine pain pump. Throughout the procedure I hit the pump the whole time. I am interested if someone else has a similar story, and what to expect for the PTC as in pain??
amirhosein
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Apr 29, 2014 @ 6:06 am
my father have cbd cut off during surgery and then had anastomoz surgery . after 3 moth bile duct blocked and by interventional radiology metal stent has beeb inserted. now after 10 month stent blocked and dr suggest surgery, is there anyway that by interventional radiology stent extract or is there any drug that can solvent metal stent? please
gwyneth
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May 30, 2014 @ 10:10 am
My 68 year old mother had a Liver Transplant approx 6 weeks ago she was on the urgent list as she was critically ill.

She returned to the hospital after picking up a virus and also to be told her bile duct was a leaking and after being given a bag to drain away the fluid had a small procedure to have a stent placed in her body.She is very very weak and and fluid still collects in the bags 8 days after the stent being placed ..Please , she would like to know if this should still be happening ?
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Aug 22, 2014 @ 1:01 am
My father is about 83 years old. A plastic stent was placed in his cbd on 30-07-2012. It was functioning properly but was replaced after 15 months with another plastic stent. How long can a plastic stent be allowed to stay in cbd?
Norman Elliott
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Aug 25, 2014 @ 10:10 am
My Husband is 81 years old and had his gallbladder out June the 4th 2014 after having a gall stone removed from the duct May 14th 2014. Returned to hospital on the 15th of July. He was having chills and fever over 100 temp. They went back into the duct and removed the infection and cleaned duct and replaced stent. Back to hospital on August 20 with pain, and yellow skin and very dark urine. They went again Aug. 21. 2014 into the duct and put in a larger stent and there was no infection. They told us that the stent has to be removed in two to three months or sooner if he has a problem. Is this a normal procedure? How many times do we have to replace the stints? Thank you, for your help. Norm
joan
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Oct 2, 2014 @ 4:16 pm
What foods,if any, should be avoided after a bile duct stent was inserted because of a blockage, which may be cancerous
dr alamzeb
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Oct 3, 2014 @ 10:10 am
my father, 63 yrs old developed fever and jaundice. one day he suffered severe abdominal pain. on investigation cholangitis was diagnosed because of de-novo common bile duct stone. then he developed sepsis and severe chest infection. ERCP was done to insert a stent in the cbd. general condition improved and the liver profile improved but not completely normal. few days back (one month after the previous procedure)stent was removed but the Liver profile is still deranged ,even worse and there is fever. what should be done next?
sissy
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Oct 9, 2014 @ 4:16 pm
hello i am 49 yers old i have a common bile duct sticture when i had my gall bladder removed in 2010 almost died with 2 infections but that past now to make along, long story short i have had my metal stent in now since 2011 the plastic ones didn't work so the dr. decided to put a metal one in so i wouldn't have to keep having a new one in every 4 months i thought i wouldn't be able to work anymore i do hard manual work and it's really hard at times i was just wanting to ask anyone to see how long the metal stent can stay in before problems occur? i'm starting to have alot more and different pain now also i have pacreeitius due to all the ERCP'S i had, do i need to get another opinion or go back to the same dr.? he said iwouldn't have to get it removed and one other dr. told me yes i do. been going to pain management for 4 years now. thanks for any help
Wendy
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Nov 14, 2014 @ 12:00 am
Bile Duct Stent Removal

Hi I am a 53 year old lady - can anyone tell me how long a metal stent can remain in the bile duct?
Mine has been in for 5 month. I had a complex gallbladder removal and a perforated bile duct that was stitched up. I have varices and had an internal bleed. I am due to have it removed in a couple of weeks and am really scared in case something goes wrong. I have already suffered acute Pancreatitis from an ERCP.
Many Thanks for replies.
Karen
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Nov 17, 2014 @ 7:07 am
I went in 3 days ago to get my gallbladder removed since I have been in pain since July. 4 months. During the procedure I had a ERCP and it shoed a narrowing at the end of the common bile duct at the opening of the pancreas. The only symptom I have is weight loss. After the gallbladder removal I feel great. Can seem to eat anything. I am going in for a MCRP this week. Is this a condition that can just require a stent or do I necessarily have cancer? All blood work is normal. This is causing me great anxiety so if you could give me an answer I would be very grateful!
Jim
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Nov 22, 2014 @ 11:23 pm
For those with biliary stricture or leak post gall bladder removal, metal stents are fine. However, they should not be left in for more than 4 to 6 months depending on the level of stricture. After that, they usually cause problems and can be difficult to remove. They are much less likely to get blocked than the plastic ones and the self expansion will greatly increase the chance of remaining stent free after their removal. There seems to be a lot of mis information that has been provided to patients and family. It is important to distinguish between cancer patients and benign issues. I have had 7 ERCPs and five sets of stents. It is important to use a surgeon that is regularly or exclusively performing ERCP.

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