# Biliary stenting and drainage

Source: https://onco.cc/technologies/biliary-stenting-drainage/  
OnCo record `biliary-stenting-drainage` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A small tube placed by endoscope or through the skin reopens a blocked bile duct, relieving jaundice so chemotherapy can be given.

## Summary

Most patients with perihilar or distal bile duct cancer present with obstructive jaundice; ERCP-placed plastic or metal stents, or percutaneous transhepatic drainage, are required before systemic therapy (bilirubin must fall) and before surgery in selected cases. Endoscopic ultrasound-guided drainage and radiofrequency ablation of the stricture through the stent are newer adjuncts.

## Fields

- Kind: Technology
- Status: standard-of-care
- Last checked: 2026-09-07
- Principle: Restore bile flow across a malignant stricture; self-expanding metal stents stay patent longer than plastic.
- Strengths: Rapid symptom relief; Enables chemotherapy dosing
- Limitations: Cholangitis and stent occlusion; Pre-operative drainage is debated for resectable disease

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Biliary_stent
- Wikipedia: https://en.wikipedia.org/wiki/Biliary_stent
- Cancer Research UK: biliary stents: https://www.cancerresearchuk.org/about-cancer/bile-duct-cancer/treatment/stents
- Almadi et al., plastic versus self-expandable metal stents for palliation in malignant biliary obstruction, meta-analyses (Am J Gastroenterol 2017): https://doi.org/10.1038/ajg.2016.512
- Pancreatic Cancer UK: stent for a blocked bile duct: https://www.pancreaticcancer.org.uk/information-and-support/treatments-for-pancreatic-cancer/stent-for-a-blocked-bile-duct/
- NICE NG85: pancreatic cancer in adults, diagnosis and management, recommendations: https://www.nice.org.uk/guidance/ng85/chapter/Recommendations

## Connected records

- cancers: [Ampullary cancer (ampulla of Vater)](https://onco.cc/cancers/ampullary/), [Biliary tract cancer (cholangiocarcinoma)](https://onco.cc/cancers/cholangiocarcinoma/), [Borderline resectable pancreatic ductal adenocarcinoma](https://onco.cc/cancers/borderline-resectable-pdac/), [Cystic duct carcinoma](https://onco.cc/cancers/cystic-duct-carcinoma/), [Extrahepatic cholangiocarcinoma (perihilar and distal)](https://onco.cc/cancers/extrahepatic-cholangiocarcinoma/), [Gallbladder cancer](https://onco.cc/cancers/gallbladder/), [Locally advanced unresectable pancreatic ductal adenocarcinoma](https://onco.cc/cancers/locally-advanced-pdac/), [Metastatic pancreatic ductal adenocarcinoma](https://onco.cc/cancers/metastatic-pdac/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/), [Resectable pancreatic ductal adenocarcinoma](https://onco.cc/cancers/resectable-pdac/)
- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/), [Surgery & Interventional](https://onco.cc/fronts/surgery/)
- terms: [Biliary drainage routes: ERCP stent, percutaneous (PTC) and EUS-guided](https://onco.cc/terms/biliary-drainage-routes/), [Biliary stent problems: blockage and infection](https://onco.cc/terms/biliary-stent-problems/), [Cholangitis: infection of a blocked bile duct](https://onco.cc/terms/acute-cholangitis/), [Living with jaundice and itching (biliary cancer)](https://onco.cc/terms/jaundice-and-itch-biliary/), [Palliation in pancreatic cancer: biliary and duodenal stents, coeliac plexus block, enzymes and cachexia](https://onco.cc/terms/pancreatic-palliation-obstruction-pain-nutrition/), [Stent or bypass for jaundice: the choice](https://onco.cc/terms/stent-or-bypass-for-jaundice/)
- trials: [TESLA RCT](https://onco.cc/trials/tesla-rct/)

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