Gastroenterology - Pre-ERCP information about possibility of insertion of a Biliary Stent

This information is for patients being considered for an ERCP (Endoscopic Retrograde Cholangio Pancreatography) and should be read in conjunction with the Trust’s patient information leaflet about the ERCP procedure.

At the time of ERCP, it is sometimes necessary to insert a stent (plastic or metal tube) in order to overcome a blockage in the bile duct or the pancreas.

When these stents are inserted, they may be inserted for a temporary use with a plan of endoscopically removing them or replacing them after a period of time. Stents may also be inserted permanently where the plan is for the stent to remain in place long term.

Risk associated with biliary stent insertion include some complications that can happen during or immediately after the stent insertion and some complications that can occur days, weeks or even months after the stent insertion.

Immediate complications can include:

• Risk of infection
• Bleeding
• Tear or perforation
• The development of pancreatitis

These complications are serious and could in some circumstances lead to death.

Longer term complications can include blockage of the stent with the risk of development of infection.

Symptoms suggestive of infection include:

• Feeling feverish
• Flu-like symptoms
• Chills or shakes (rigors)
• Abdominal pain, and
• Jaundice (skin or eyes turning yellow, urine turning dark)

These complications will usually be treatable but on some occasions will have lasting effects. These complications could also lead to death.

Temporary Biliary Stents

After the ERCP procedure, we will let you know whether a stent has been inserted on a temporary basis with a plan to remove it. We will let you know the length of time that we intend for the stent to remain in place before we ask you to return for a repeat ERCP and stent removal or stent replacement.

We are currently experiencing some capacity problems and therefore some patients are having to wait longer than expected on our waiting list for the removal of temporary stents. This means that there is the possibility that the removal of your stent might be delayed. We are doing everything possible to try and minimise the risk of delay.

One of the consequences of this is that when we ask you to come back for the stent removal, it is possible that stent removal may take place in a different hospital outside of The Northern Care Alliance NHS Foundation Trust.

If the stent stays in beyond the recommended date then there is a risk of infection developing around the stent and in the bile duct, which can sometimes lead to serious infection, including the risk of septicaemia and death. Delayed removal can also make it more difficult for the stent to be removed.

Permanent Biliary Stents

We will let you know in the ERCP report and in a patient information leaflet after the procedure if a stent has been inserted with the plan for this to be in place permanently.

Permanently placed biliary stents can be associated with complications in a small number of cases and these can include blockage of the stent which may lead to pain, jaundice or infection.

If this happens then sometimes it is necessary to perform a further ERCP to relieve the blockage.
 
I have received and understand the information and medical advice provided to me about my biliary stent.

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