Biliary Drain & Stent Placement

Biliary drainage and stent placement procedures allow for drainage of an obstructed biliary system through a catheter placed through the skin into a bile duct within the liver. These procedures are frequently performed on patients with symptomatic obstructive jaundice most often the result of a malignant process (such as pancreatic, biliary or liver cancer) or a benign process (such as gallstones, common bile duct stones or benign strictures).

When is the procedure recommended?

The most common indication for biliary stenting is for treatment of obstructive jaundice from either benign or malignant causes. On occasion, stents are placed for management of bile leaks.

How is the procedure performed?

A series of dilators, guide wires and catheters (tubes) are advanced toward and through the area of obstruction to establish an internal or external drainage path. The path may provide permanent or temporary drainage of bile fluids into the first portion of the small intestine or externally into a bag.

In some circumstances of malignant disease, an internal metal stent may be placed during a follow up procedure at the area of obstruction as a form of permanent treatment. In the circumstance of a benign process, the drain tube may be left in place to drain internally or externally into a bag for several months.

Biliary drainage procedures involve the use of ultrasound and fluoroscopic imaging to map patient anatomy. A local anesthetic is injected. A hollow needle is inserted through a small incision in the skin, into a bile duct (within the liver). A small amount of contrast (dye) is injected into the catheter to verify its proper placement.

What are the benefits?