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Bilary stenting: 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). photo

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

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).

Endoscopic biliary stenting is an alternative to surgery for the initial treatment of jaundice and cholangitis in patients with biliary strictures due to chronic pancreatitis.

The morbidity and mortality rates associated with biliary stent insertion are low. Endoscopic therapy appears to be effective in this situation; however, should be considered an alternative to surgery only in high-risk surgical candidates.

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