How do doctors remove a covered biliary stent?

Removing a covered biliary stent is typically done using endoscopic retrograde cholangiopancreatography (ERCP), a minimally invasive procedure. Here's how doctors generally approach it:

1. Sedation

• You’ll receive sedation or general anesthesia to keep you comfortable and relaxed during the procedure.

2. Endoscope insertion

• A flexible tube (endoscope) is inserted through the mouth and down into the stomach, reaching the duodenum, where the bile duct opens.

3. Identification of the stent

• The doctor uses imaging (usually fluoroscopy, which is live X-ray) to locate the stent within the bile duct and assess its position.

4. Stent removal

• The doctor carefully inserts a special stent removal device through the endoscope to grab the stent.

• Depending on the stent type, they may pull the stent out in one piece, or in some cases, they may have to break it into sections if it has become damaged or hardened over time.

5. Check for complications

• After removing the stent, the doctor checks the bile duct for any signs of injury, blockage, or infection. The bile duct is also assessed for proper bile flow.

• In some cases, a new stent may be placed if the bile duct is still narrowed or blocked.

6. Recovery

• You’ll be monitored for a few hours after the procedure to ensure you don’t experience complications like infection or bleeding.

• Once you're stable, you can typically go home the same day.

Risks to monitor for:

• Infection (cholangitis)

• Bleeding from the bile duct or injury to surrounding structures

• Pancreatitis, though this is rare

In some cases, if the stent has become embedded or very difficult to remove, a percutaneous (through the skin) approach may be used, where a needle is inserted through the skin to access the bile ducts.

Would you like more details about how doctors handle stent complications during removal?