How do they insert a stent in the bile duct?

Here is a brief overview of how a bile duct stent is inserted:

- The procedure is done under sedation or general anesthesia. An endoscope (long, flexible tube with a camera) is inserted through the mouth, down the esophagus, and into the small intestine.

- Using X-ray guidance, a thin tube called a catheter is inserted through the endoscope and guided to the blockage in the bile duct. A guidewire is then threaded through the catheter.

- The catheter is removed, leaving just the guidewire in place. The stent (a small mesh tube) is loaded onto the guidewire and guided to the blockage site.

- Under x-ray guidance, the doctor deploys the stent, expanding it to hold the bile duct open. The guidewire is then removed.

- After placement is confirmed with an x-ray or other imaging, the endoscope and all other instruments are withdrawn. 

- The stent remains in the bile duct to keep it open and allow bile to drain normally from the liver and gallbladder into the small intestine. This helps relieve jaundice and other symptoms.

- The stent procedure usually takes 30-90 minutes. Patients typically stay in the hospital for a period of observation afterward before being discharged home.

 So in summary, bile duct stents are inserted using an endoscope and guidewire to access the bile duct, then the stent is positioned across the blockage and expanded to keep the duct open.