A pancreas stent is a small, hollow tube placed inside the pancreatic duct, the channel that carries digestive fluids from the pancreas to the small intestine. Its purpose is to facilitate the drainage of pancreatic fluids or to keep the duct open when it is narrowed or blocked, preventing complications from fluid buildup.
What is a Pancreas Stent?
Pancreas stents vary in size and composition, ranging from 3F to 11.5F in diameter and 2 to 25 cm in length. They are commonly made from polyethylene, a medical-grade plastic, and can also be made from metal.
Pancreatic stents come in various designs, including straight, curved, wedge, or single pigtail shapes. Most plastic stents feature side holes to allow drainage from smaller pancreatic side ducts. Some, like pigtail-shaped stents, incorporate a mechanism to prevent internal migration. The choice between plastic and metal stents depends on the expected duration of placement; plastic stents are used for temporary relief, while metal stents, such as self-expandable metal stents (SEMS), are chosen for longer-term use, especially for malignant obstructions.
Why and When Pancreas Stents Are Used
Pancreas stents address obstructions or issues within the pancreatic duct system. They relieve blockages caused by gallstones, which can travel from the gallbladder and obstruct the pancreatic duct, leading to gallstone pancreatitis. Stents also manage strictures, narrowings of the pancreatic duct that can result from chronic pancreatitis, trauma, or tumors.
These devices restore the proper flow of pancreatic secretions, reducing intraductal pressure and alleviating associated pain. Stents can also be placed to seal disruptions or leaks in the main pancreatic duct, or to drain fluid collections like pseudocysts that may form due to pancreatitis or trauma. A pancreatic stent may also be placed preventatively to reduce the risk of pancreatitis following endoscopic procedures involving the pancreatic duct.
The Stent Placement Procedure
The most common method for inserting a pancreas stent is through Endoscopic Retrograde Cholangiopancreatography (ERCP). This minimally invasive procedure takes between 30 to 60 minutes. Patients receive sedation for comfort throughout the process.
During an ERCP, a thin, flexible endoscope with a camera is guided through the mouth, esophagus, stomach, and into the duodenum. Once the endoscope reaches the pancreatic duct opening, a catheter is advanced into the duct. A contrast dye is injected, making the ducts visible on X-ray images, allowing the doctor to identify blockages or narrowings. With X-ray guidance, the stent is then inserted into the pancreatic duct to open the narrowed area or facilitate fluid drainage.
Living with a Pancreas Stent
After pancreas stent placement, patients experience a short recovery period, involving a hospital stay of one to two days. Mild symptoms may include a sore throat for a day or two, or abdominal discomfort and bloating, which subside within a few hours. Following the procedure, X-rays are needed within three to four weeks to confirm the stent remains properly positioned.
Patients with temporary plastic stents require follow-up for stent removal or exchange, as plastic stents can become occluded and need replacement every three to six months. Metal stents, such as self-expandable metal stents (SEMS), offer longer patency, lasting 8 to 12 months, and are used for long-term management, especially for malignant obstructions. While living with a stent, it is important to monitor for signs requiring medical attention, such as fever, severe or worsening abdominal pain, or jaundice (yellowing of the skin or eyes), as these could indicate complications like infection, stent blockage, or migration.