I have been informed both my left and right ducts are blked. My doc says my left duct is completely blocked and i need to get a percutaneous intravention procedure to get it opened. Then they plan on placing plastic stents. Has anyone had stents placed? Whats the exp. like, does it hurt?
Forgot to mention stents will be placed thru ERCP
I've had stents placed. No big deal. Immediate relief to enzyme and itch problems. Be advised, stents need to come out in about three months. That was a surprise to learn afterward.
I've had many ERCPs for stent placement. Easy procedure and you'll feel waaaay better once they clean out the glop, put in stent and bile flows freely. Only prob is, if they give too much sedation, you may be nauseous afterward, but then too little.... well you wouldn't want to wake up during procedure. My doc has the amt exactly right. Just had stent replaced yesterday, slept rest of day and most of today!
I went in with a decompensated liver and had to have a stent put in. They did it during an ERCP. From what I am told the liver has no pain receptors and I had no particular pain involved with it from my experience. It actually saved my life, or kept me from needing an immediate transplant.
I have had many stents placed and removed. The first time I had one placed, it apparently had come undone and left my body. They switched types of stent, and they all stayed put after that. I didn't feel a thing in my liver or torso area, even when the stent went away. I would not worry about any liver pain. Good luck.
I used to wait until I contracted an infection and then go in for a stent replacement (and subsequent IV antibiotics, days in the hospital, etc). Now my doc routinely exchanges out my stint every three months. Haven't been in the hospital since last December. What a difference! Easier planning the vacation too.
I'm on the 3-month stent change plan too, but I sometimes don't last that long and end up in the hospital with cholangitis. I get the IV antibiotics first for a few days, then the stent change following it. Flareups always seem to happen at the most inopportune times, have had cancelled plans, vacation, appts a few times.
I was changing stents about every 5-6 weeks, but then started to be able to last only about 2 weeks. Then my husband would have to drive me to the hospital (2 and 1/2 hours in my case), where I would have to stay a few days, get cleaned out, do anti-bios, etc. The doctors have decided to go without stents for me and put me on prophylactic antibiotics, rotating different types. They are trying to keep me as infection-free as possible while I wait for a donor. This has worked for me so far (knock on wood). I have been on the transplant list in Michigan for 7 months now. I know people have waited much longer, but it seems like I will never get the call. I have a rare blood type (B+), which doesn't help matters. I am in the process of moving my registration to Henry Ford Hospital so they can evaluate my brother as a possible living donor. He is B+ also, and is more than willing to donate to me. The University of Michigan Hospital does not have a living donor program, so I am forced to move. I know I have gone a little off topic here. Thanks for reading. Good luck with your stents. As you have probably gathered, PSC is different for everyone, so try to be patient with some of the "trial and error". I know it is very difficult.
K-del - Great that the abx are working for you. Whenever I'm without a stent, it's only a matter of a few wks before I'm in bad trouble yet again. In hospital, I'm on IV Pip Taz. Have you been on that one? Am also B+, didn't realize it was rare. My father was AB neg and I was glad to find out that I didn't inherit it. You are fortunate to have a possible living donor, that sheds a whole different light on the process. I was scheduled to have pre-transplant 2-day assessment a couple wks ago and woke up with 102° fever, chills, nausea etc (cholangitis episode for a change..) and was not fit to travel the 3 hours... or do much else for that matter so had to cancel. Hadn't been sick since before last ERCP/stenting mid June... but this is the day it picks to flare up! Good luck at HF hospital!
Alix-- Sorry you had to miss your evaluation. Hopefully, the next date will find you healthy enough to go the appointments. It is frustrating for me because I already went through ALL of the meetings, evaluations and testing to get on the list at U of M. Now, I have to do basically everything again to be officially registered with HF before my brother can even come into the picture. It just seems like a waste of time to me. I guess I have to take my own advice and be patient. :) I am actually heading there this Friday to do some of the meetings (surgeon, nutritionist, etc.), so at least the ball will start rolling.
I believe B+ is the blood type for only about 8-9% of the population in this country. It is more prominent in other countries/ethnic groups from what I understand. I am not an expert, though.
Okay, I have fully hijacked this thread without meaning to. I apologize to Mike, the OP for that. Mike, I was nervous when I got my first stent, also. Pretty soon, for better or worse, having ERCPs will almost become "old hat".
I know everyone is different with their PSC…, I was just diagnosed with it at the end of Dec., previously they thought I had PBC. After 2 years they (group of specialists at the Univ. of Chicago) felt my numbers didn’t add up to that and more towards PSC. I have had a liver biopsy, numerous MRI/MRCPs and labs every 3 months, steroid therapy, been on Urso and now they have taken me off all meds due to not helping…approx when did you start to have these stents put in and how were your “lab numbers” Alk Phos, Alt, Ast ect when it all started?
Mike,
In my opinion, Stents are not a big deal except that they have to come out after a few months. The Percutaneous aspect may mean you’ll be getting a PTC. Percutaneous Transheptic Cholangiography which is a method of imaging the liver to see which ducts are open or strictured. They access the liver from the outside, through the ribs. In my case they left the catheter in place for a few months. It’s kind of a pain in the butt having the catheter sticking out of your side, but at least it keeps the ducts open and flowing. And in my case it ended up contributing to my Portal Artery rupturing and moving me to the top of the Tx list. I got my new liver 2 days later.
Mike in KY
Mike - I also was thinking that the procedure you're having (or have already had?) is percutaneous transhepatic biliary stenting and figured I had it wrong in my earlier reply, but you added that it'll be done through ERCP. Percutaneous is through the skin vs internal stent done via ERCP (endoscopic procedure). ?
K-del - Have you had PTC? I haven't (yet..)
Hi Mike - I've had 41 ercp's. and the biggest problem was the very first. My common bile duct was completely blocked and had to be lasered open. Had a lot of throwing up afterwards. So much backed up stuff. My comments are similar to others - usually feel better, relieves pressure in epigastric area, removes itching and up and out in 3-4 hours depending on sedation used. Mine are always done with intubation now because sedation isn't strong enough to keep me sleeping during procedure. In fact had ercp yesterday and one of the bile ducts is blocked and they couldn't pass wire through. Still in hospital waiting to hear what the plan is. So I'm going to look up the procedure you mentioned as I've never had that. Best of luck.
Just to comment on your comment Alix - tomorrow I'm having a percutaneous with a scope. So as I understand they use the percutaneous to get to a spot not accessible by scope; in my case above the blocked bile duct. they will also have the scope in which I imagine is necessary in the event they are able to get through. The scope helps clean, stretch, picture area. I'll let you know how it goes. #42 ERCP tomorrow - woo hoo!! : ) Deb
Alix said:
Mike - I also was thinking that the procedure you're having (or have already had?) is percutaneous transhepatic biliary stenting and figured I had it wrong in my earlier reply, but you added that it'll be done through ERCP. Percutaneous is through the skin vs internal stent done via ERCP (endoscopic procedure). ?
K-del - Have you had PTC? I haven't (yet..)
Deb - Thanks, that makes sense now. Hope all goes well tomorrow. 42 ERCPs- wow! And here I thought I was a frequent flyer at 11 (#12 next mth).
All the best Deb. I will pray all goes well for you. I had my procedure done a few weeks ago. They used a wire to get in externally and then placed a stent using ERCP. Actually, i went in last week to get the stent removed. All seems ok so far. My results are showing improvements. Warranty is maybe a year but it all depends per my doc. Lets see.
greatdane61 said:
Just to comment on your comment Alix - tomorrow I'm having a percutaneous with a scope. So as I understand they use the percutaneous to get to a spot not accessible by scope; in my case above the blocked bile duct. they will also have the scope in which I imagine is necessary in the event they are able to get through. The scope helps clean, stretch, picture area. I'll let you know how it goes. #42 ERCP tomorrow - woo hoo!! : ) Deb
Alix said:Mike - I also was thinking that the procedure you're having (or have already had?) is percutaneous transhepatic biliary stenting and figured I had it wrong in my earlier reply, but you added that it'll be done through ERCP. Percutaneous is through the skin vs internal stent done via ERCP (endoscopic procedure). ?
K-del - Have you had PTC? I haven't (yet..)
So Mike - how was the procedure for you - pretty much like going thru ercp? Any residual symptoms from the percutaneous part? Thanks for the good thoughts. My procedure has been postponed primarily because only a few partners in gastro practice do these types of procedures. Oh and I got ahead of myself - ha, ha - the next one is #41. but you know whose counting? I decided when the PSC returned I'd keep count. I had 24 before transplant. My PSC really hits the common bile duct and the left bile duct so lots stenting. In some ways it is a good experience because I've had the last dozen done at one place so I know the nurses and techs and many of the anesthesiologists. Always on time, friendly, remembers my name. In 2011 I had 6 done - just required more stretching and some stenting. I have met a peer that was over 50. I will probably get there myself, never could imagine it tho.
I did have my first paracentesis today to pull off ascites. Never encountered this problem before. So I can safely say this is a very simple easy procedure with lidocaine shots only to get numbness and then a small incision and tube inserted. The fluid is then suctioned out. I am the proud parent of 3 liters of 'it'. :)
While I was there I asked the radiologist to explain the PCT procedure in more detail. A long thin needle is inserted into liver via interventional radiology - IR. Then a thin wire is inserted in same space. Needle out and wire guided to bile duct. They then pass ever increasing tubes into stricture with the hopes of getting through as it is stretched.
Really hope they can get the duct open. Thanx for help and thoughts. Cheers Deb
I had a stent put in about 8yrs ago prior to my transplant . Mine was put in by endoscope . ( by going down my throat and through my stomach ). I have to admit this was not one of my most enjoyable moments . It must have taken about half an hour , but they did give me some sedation .
Don't know if this is how they intend to do yours , it depends where the blockage is . Sometimes they have to go through your side. But they numb the area well first so it shouldn't be to bad . Will pray for you that all goes well. Olease post how it goes .