Stagnation of bile in the liver leads to the development of diseases such as stomach and duodenal ulcers, pancreatitis, cholecystitis, cirrhosis. All these pathologies in advanced stages end in the same death. In this regard, a unique and at the same time simple method was found to restore the digestive system - stenting of the bile ducts.
The essence of the technique
Stenting was the result of a technique for restoring the lumen of blood vessels in the human body. A stent was inserted into the vessel, providing a high-quality supply of blood to the organ, brain, and so on. Currently, stents have been installed in the bile ducts, thereby ensuring a normal outflow of bile, which has a beneficial effect on the digestive system.
The device is a plastic hollow tube of the desired diameter. It is easily installed in the duct, increasing its lumen, decreased as a result of any disease.
Stenting of the bile ducts is a painless and bloodless procedure, which can significantly reduce the time for rehabilitation after it, in contrast to a full-scale surgical operation.
Indications for stenting
Stenting of the bile duct is performed to restore the outflow of bile, impaired as a result of one of many diseases of the liver and digestive organs. These include:
- The formation of a cyst is large enough to block the duct.
- Jaundice of infectious origin.
- Tumors of a different nature, affecting the duodenum.
- The presence of stones in the bile ducts.
- Metastases in the liver, gall bladder and digestive organs.
- Chronic inflammation of the pancreas.
- Chronic cholecystitis is an inflammation of the gallbladder.
Stenting of the bile ducts with a tumor is prescribed in any case. In other diseases, the procedure is indicated only after drug treatment, which has not had a therapeutic effect.
Stenting is prescribed only by a specialist, after a thorough examination of the patient.
Contraindications to stenting
What is bile duct stenting? This is a simple but still surgical operation. In this regard, there are a number of contraindications to this procedure, caused by the patient's condition:
- Complete or partial intestinal obstruction.
- Bleeding formed by various tumors.
- The bile duct is narrowed so that the stent is simply impossible to install.
- An excess or other congenital malformation of the bile duct.
- Presence of adhesions in the duct.
- Hardening of tissues in the duct - strictures.
In particularly complex cases, stenting is still performed, but not by the endoscopic method, but by percutaneous penetration of the damaged duct.
Preparation for the procedure
An important aspect for the successful implementation of the stent installation procedure is the proper preparation of the patient for it. First of all, a biochemical analysis of blood is carried out and studies on the rate of its coagulation.
The digestive organs are studied using various instrumental techniques - radiography, ultrasound, and magnetic resonance imaging.
All this is done in order to establish not only in which exact place the duct was blocked, but also what caused it.
Moreover, in the process of research, the size of the stent for each patient is determined individually.
The patient must undergo examination by an anesthetist, since the procedure is performed under general anesthesia. Each person may have a reaction to a particular drug for anesthesia.
Immediately 10-12 hours before the procedure, the patient is transferred to a zero diet. You can’t eat, but you can drink only clean water in limited quantities.
Stenting of the gallbladder ducts lasts from 20 minutes to 1.5 hours, depending on the complexity of access to the duct, the patient’s anatomy, and the number of stents to be installed. It so happens that you need to install 2, 3 or more stents at a time. For example, when bile duct stenting is performed for pancreatic cancer.
Methods of the procedure
In order to avoid complications after surgery, for each patient, according to his individual indications, the procedure is selected:
- Endoscopic method. This technique is the penetration and installation of a stent into the bile duct with a special tool - a metal tube with a video camera and tools built into it. The tubes are usually 2, 3 or more. The procedure requires a certain skill from the surgeon, so it is carried out by the most experienced specialist. The operation is bloodless, and does not require a long postoperative period. After it, a barely noticeable trace from the inserted tubes remains on the patient’s skin.
- Percutaneous method. In this case, the stent in the bile duct is installed after direct penetration to the affected area through the skin and soft tissues of the patient. The procedure is performed under general anesthesia, after it remains a noticeable scar from the incision, and the postoperative period takes 2-3 weeks. During it, the patient is observed for the occurrence of inflammation in the skin incision and possible bleeding.
Complications
In general, the described procedure is simple, and after it the patient quickly recovers. But after stenting of the bile ducts, various complications can be observed due to unforeseen factors, low qualification of medical personnel and anatomical features of the patient's body. These include:
- pancreatitis
- inflammation of the ducts of the gallbladder itself;
- clogging of the expander;
- rupture of smelt of the bile duct under stent pressure;
- stent displacement, accompanied by damage to the duct walls;
- bleeding.
General statistics show that complications of bile duct stenting occur in 2% of patients.
Advantages of the procedure
Reviews about stenting of the bile ducts with a tumor or other pathologies are positive. So, the advantages of the procedure include:
- time - no more than 2-3 hours;
- quick rehabilitation of the patient - he should not be in a hospital for a long time;
- a small percentage of complications;
- preservation of the bile ducts - they do not need to be removed.
All this allows you to quickly recover throughout the digestive system.
Rehabilitation after stenting
Patient recovery after surgery takes about 2 weeks. And all this time he must follow the recommendations of the attending physician:
- Adhere to bed rest.
- Follow the prescribed diet.
- Continue medication for complete recovery. This is usually a course of antibiotics and drugs that strengthen the immune system.
- Avoid physical exertion.
- Do not take hot baths.
- In case of any violation of health, immediately inform the doctor.
Diet after stenting
Nutrition after stenting of the bile ducts is strictly regulated by the attending physician. Moreover, it is necessary to adhere to certain rules in nutrition throughout life, since their violation can lead to relapse, that is, narrowing and blockage of the lumen of the bile duct in another place. This will lead to reoperation or the development of deadly conditions.
What can and cannot be from food
First of all, fatty meat is removed from the human diet, especially cooked by frying - kebabs, steaks and so on. Fatty meat is excluded - lamb, pork, and liver. Do not eat dairy products with high fat content. All this is aimed at lowering cholesterol in the blood and, accordingly, in the bile ducts.
From these considerations, the consumption of chicken eggs, milk, cream, sour cream, sausages is sharply limited.
The need to reduce carbohydrates consumed leads to the fact that a person must abandon sweet pastries, carbonated drinks, chocolate, sweets and the like. You should reduce the consumption of white bread, but it is better to replace it with rye.
In order to reduce the risk of spasms of the ducts and blood vessels, it is necessary to abandon coffee, strong tea and cocoa.
It is strictly forbidden to drink alcohol and smoke cigarettes. Alcohol and nicotine destroy the walls of blood vessels and ducts many times faster than any wrong diet.
You can not eat canned food and dishes from fast food establishments. They are rich in artificial colors and preservatives.
The human diet should consist of fresh fruits and vegetables, greens, rich in vitamins. You need to eat soups and cereals from various cereals. Consuming fiber from these foods strengthens the intestinal wall and reduces the likelihood of gastritis and stomach ulcers. Meat must be present in the diet, but only in boiled form and only low-fat honeycombs - veal, chicken.
Fish, rich in iodine, seaweed, nuts, sunflower seeds, berries, vegetable oil, are necessarily included in the diet. All this has a beneficial effect not only on the digestive system and intestines, but also strengthens the walls of blood vessels and bile ducts.
Food should be fractional - about 7-8 times a day, but in small portions. This will allow the body to absorb all the beneficial substances from the products and reduce the risk of overeating, as well as decreased slagging of the large intestine.
Alternative methods
Stenting of the bile ducts today is the best solution to the problem of blockage of the bile ducts.
There are a number of alternative methods for restoring the outflow of bile. But they all involve extensive percutaneous surgery, during which part of the bile duct or intestine is removed. Rehabilitation after such operations is long, and the risk of complications is much higher.
In some cases, to speed up treatment and increase its effectiveness, stenting is an additional measure during procedures such as balloon dilatation, electrocoagulation, laser coagulation, and bougieurage. The decision on the need for a particular procedure remains with the attending physician.
Stenting of the bile ducts is a universal low-traumatic technique that allows you to restore digestion. The opinion of most experts confirms that this is an effective and safe method of treatment. However, the risk of complications and contraindications requires the doctor to inform the patient about other treatment options.