How do they remove a stent in ERCP?

Here are the typical steps for removing a biliary stent during ERCP (endoscopic retrograde cholangiopancreatography):Preparation:

- The patient is brought to the endoscopy suite and given sedation or anesthesia. Vital signs are monitored. Endoscope insertion:

- The endoscope (a long, flexible tube with a camera) is passed through the mouth, esophagus, and stomach into the duodenum. Locating the stent:

- Using x-ray imaging and contrast dye injected through the endoscope, the doctor visualizes the location of the stent in the bile duct. Entering the stent:

- A wire or grasping instrument is passed through the endoscope and into the open end of the stent. This may require some maneuvering to align properly. Stent removal:

- Once secured inside the stent, it can be slowly pulled back through the endoscope, collapsing and removing the entire stent from the bile duct. Confirmation:

- An x-ray image is taken to confirm complete stent removal. Additional procedures like stone removal can be done during the same ERCP.Completion:

- The endoscope is withdrawn back through the mouth. The patient recovers for 1-2 hours before being discharged. They may have a sore throat or mild abdominal discomfort. 

So in summary, biliary stents placed during ERCP can later be retrieved by reintroducing the endoscope, grasping the stent, and pulling it out through the endoscope under X-ray guidance.