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Endoscopic biliary stenting

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Biliary stents are straight or slightly curved tubes that are placed through a stricture in the biliary tree. They have a valuable role in the palliation of:

  • those with malignant jaundice
  • patients with choledocholithiasis at risk of blockage
  • those with stones not extractable by other means

They are not indicated for relatively young patients with obstructive lesions: these require surgical bypass.

The key complication of stenting is blockage. This occurs after a lag of several months, sooner for smaller stents, due to the accumulation of bacteria, mucoprotein and other secretions. Treatment is by endoscopic removal of the stent.

Self-expanding metallic biliary stents inserted percutaneously and transhepatically are presently being investigated.


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