Biliary Stents & Drain Placements

[photo1]Bile is necessary for the breakdown of fatty foods. It is formed in the liver, stored in the gallbladder, and passes through biliary ducts, where it empties into the intestine. It is possible for gallstones to become lodged in the bile duct and prevent the gallbladder from emptying. This can cause right upper abdominal pain and result in a severe infection called cholecystitis.

This diagnosis is usually made using ultrasound in combination with a clinical history and examination.  The bile ducts can become obstructed or narrowed-- most commonly because of tumor or stones. If bile cannot be excreted, patients may become jaundiced (yellow color of skin and eyes). Depending on the location of the blockage, it may be necessary to drain the bile either by placing a tube into the gallbladder or directly through the liver. Alternatively, the bile ducts may be drained endoscopically.

If tumor is present, a stent may be needed to keep the ducts open. A biliary drain may also be placed due to a hole in the bile duct causing a bile leak. Sometimes antibiotics will be given prior to procedure to prevent spreading any underlying infection.

What happens during the procedure?
Conscious sedation is provided prior to starting and throughout the procedure.You will lie flat on the x-ray table and will be connected to several types of monitoring equipment. The skin overlying the right side of the abdomen will be cleaned with an antiseptic solution and then sterile drapes are placed around the area. Some numbing medicine will be injected into the skin before the needle is inserted. Following insertion, the needle will be guided to the correct location by an x-ray camera or ultrasound machine. Depending on your condition, a drainage tube may be placed, a tissue sample taken, a stone removed, or a blockage of the bile ducts opened with a balloon catheter or stent placement.

If a drainage tube is placed it will be inserted through the skin and secured in place. It may need to stay in place for a long time to allow your bile fluid to drain. If an area of blockage is discovered, an attempt to open the blockage may be performed with a balloon catheter.

Following this, if there still is not enough bile flow through the area of blockage, a metal mesh tube_ a stent may be placed at the site to improve the bile flow.
If a tissue sample is to be taken or a stone removed, either of these procedures can be performed through the access already created in your biliary system.

This procedure takes approximately one to two hours.

What happens after the procedure?

Since conscious sedation medicine was administered, you will be required to stay to recover for two hours after the end of the procedure. While in recovery, you will be monitored closely for signs of the infection spreading into the abdominal cavity (peritonitis) and to ensure that the effects of the sedation have worn off. You must have a responsible adult available to drive/escort them home from the hospital.

If you have any questions or need to reschedule an appointment please feel free to contact the Interventional Radiology Office at 802- 847-8359. Our business hours are Monday – Friday 8:30 a.m. to 5 p.m. Someone is available to take your call after hours for emergencies.

This information is provided by the Fletcher Allen Health Care, Department of Radiology, Division of Interventional Radiology and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact your health care provider.