ERCP stents are placed into the bile or pancreatic ducts to bypass benign or malignant strictures, or narrowed parts of the ducts.

Papillary malignancy with plastic stenting. Click to Enlarge


Papillary malignancy with metal stenting. Click to Enlarge

These strictures of the bile duct or pancreatic duct are due to scar tissue or tumors that cause blockage of ductal drainage.

There are two types of stents that are commonly used by Dr. Ertan. The first one is made of plastic and looks like a small straw. A plastic stent can be pushed through the ERCP scope into the blocked duct to allow drainage by the major papilla or minor papilla in selected cases.

The metal stent is flexible and springs open to a larger diameter than plastic stents and used for malignant biliary obstructions. Both plastic and metal stents tend to clog up after several months and you may require another ERCP to place a new stent. Metal stents are permanent while plastic stents are easily removed at a repeat ERCP. Dr Ertan will discuss with you and choose the type of stent for your problem.

ERCP balloon or plastic dilators can be placed into the bile or pancreatic ducts to dilate benign or malignant strictures by Dr. Ertan. There are ERCP catheters fitted with dilating balloons that can be placed across a narrowed area or stricture. The balloon is then inflated to stretch out the stricture. Dilation can be done by plastic dilators with various sizes that can also be placed during the ERCP procedure.

After the successful dilation, a temporary plastic stent may be placed for few months. These ERCP therapeutic procedures can be done as an outpatient basis. Some patients may be admitted to the hospital for few days but most of them go home from the recovery. You should not drive a car for the rest of the day and most patients can return to full activity the next day. The overall ERCP complication rate requiring hospitalization is 6-10% according to the US experience.

Although this rate is lower in Dr. Ertan's personal experience during the last 34 years, depend on your age, your other medical problems, what therapy is performed, and the indication of your procedure, your complication rate may be higher or lower than the average. Dr. Ertan will discuss your likelihood of complications before you undergo the test. It is important to read/understand the available pamphlets/write-ups regarding your procedure indication(s), limitations and complications. Then, sign the properly explained consent form.