Transhepatic Stenting

What is Transhepatic Stenting?

Transhepatic Stenting is a minimally invasive procedure used to open blocked or narrowed bile ducts by placing a stent to allow bile to flow freely from the liver to the intestines. It is often employed in cases of bile duct obstructions caused by strictures, tumors, or complications of liver diseases.

Key Features of Transhepatic Stenting

Minimally invasive, performed under imaging guidance
Effective for relieving jaundice and associated symptoms
Uses fluoroscopy or ultrasound for precise stent placement
Can be performed as a palliative or curative procedure

When is Transhepatic Stenting Needed?

Transhepatic stenting is indicated in patients with bile duct obstructions due to:

Malignant Causes: Tumors such as cholangiocarcinoma or pancreatic cancer
Benign Strictures: Scarring or narrowing of the bile ducts
Gallstone Disease: Stones causing biliary blockage
Liver Transplant Complications: Post-surgical strictures
Primary Sclerosing Cholangitis: Chronic inflammation leading to bile duct narrowing

How is Transhepatic Stenting Performed?

The procedure is typically performed by an interventional radiologist:

Imaging Guidance: Ultrasound or fluoroscopy is used to locate the bile duct obstruction.
Access: A needle is inserted through the skin into the liver to access the bile ducts.
Stent Placement: A stent is guided through the obstruction to restore bile flow.
Confirmation: Imaging is used to confirm proper stent positioning and bile flow restoration.

Benefits of Transhepatic Stenting

The procedure provides significant advantages for patients, including:

Relief from jaundice and associated symptoms like itching and fatigue
Improved liver function and bile drainage
Minimally invasive approach with shorter recovery times
Allows for further treatments, such as chemotherapy, in malignant cases

Risks and Potential Complications

While generally safe, transhepatic stenting carries some risks:

Bleeding or bruising at the insertion site
Infection of the bile ducts or liver (cholangitis)
Migration or blockage of the stent
Rarely, injury to surrounding organs or tissues

Patients are monitored closely after the procedure to manage any potential complications.

What to Expect After the Procedure

Recovery from transhepatic stenting is typically quick, with most patients experiencing:

Improved bile drainage within hours to days
Minimal pain or discomfort at the access site
Follow-up imaging to monitor stent function and position
Occasional stent replacements depending on the type of stent used