How is an intestinal stent placed during ERCP?

Placing an intestinal (or biliary/pancreatic) stent during ERCP is a minimally invasive endoscopic procedure performed by a gastroenterologist. Here’s a step-by-step overview of how it’s typically done:

1. Patient Preparation

• Fasting for 6–8 hours before the procedure.

• Sedation or anesthesia is administered to keep the patient comfortable.

• Monitoring of vital signs during the procedure.

2. Insertion of the Endoscope

• A side-viewing endoscope (duodenoscope) is passed through the mouth, down the esophagus and stomach, into the duodenum (first part of the small intestine).

3. Cannulation of the Duct

• The doctor locates the ampulla of Vater, where the bile and pancreatic ducts drain.

• A small catheter is inserted into the bile duct or pancreatic duct under X-ray guidance (fluoroscopy).

4. Imaging and Diagnosis

• Contrast dye is injected to visualize the duct system and identify the blockage or stricture on fluoroscopic images.

5. Stent Placement

• A guidewire is passed through the narrowed or blocked area.

• Over the guidewire, the stent (plastic or metal) is advanced and deployed across the stricture or obstruction.

• The stent self-expands (if metal) or is pushed into place (if plastic) to open the passage and restore flow.

6. Completion

• The endoscope and all tools are withdrawn.

• The patient is monitored during recovery, often discharged the same day unless complications arise.

Purpose

The stent helps relieve symptoms such as:

• Jaundice

• Abdominal pain

• Nausea/vomiting

• And prevents further complications like infections or bile buildup.

Would you like a diagram to visualize this process?