Overview

Biliary stenting is a procedure to hold the bile duct open in patients suffering from a blockage or partial blockage of the bile duct that has not responded to medical management. A blockage in the bile duct prevents the flow of bile from the gallbladder into the intestinal tract and can lead to a build up of bile in the liver and bloodstream. Traditional surgical intervention for patients with a blockage of the bile duct often requires surgical removal or rerouting of the gallbladder. Biliary stenting offers an alternative surgical option to restore the proper flow of bile without removing the gallbladder.

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Why it’s done

Your veterinarian may recommend biliary stenting if your pet has:

  • Abnormal liver test results
  • Physical exam findings of jaundice (yellowing of the skin and eyes)
  • Symptoms of gallbladder disease, including nausea, decreased appetite, vomiting, lethargy, and pain
  • Ultrasound findings of a large distended gallbladder

How to prepare for your pet’s procedure

Before your pet’s procedure, you will meet with one of our specialists to talk about the procedure and what to expect.

When you meet with our team, please bring a list of all medications that your pet is currently taking, including over the counter medications, vitamins, and herbal supplements. Before your pet’s procedure, you may be asked to discontinue giving certain medications that can increase the risk of bleeding.

This is a good time to ask questions about the procedure and make sure you understand the risks and benefits.

Preoperative diagnostics and tests

Before your pet’s biliary stenting the following may be indicated:

  • Comprehensive blood panel
  • Radiographs (x-rays)
  • Ultrasound

General Instructions for the Day of Surgery

  • Give your pet nothing by mouth after midnight the night before. This means that all food and water should be withheld.
  • Please arrive for pet’s admission promptly at your scheduled arrival time.
  • You will be asked to sign both a Surgical Consent Form as well as an Estimate, indicating your understanding of the procedure, risks, and associated costs.

What happens during a biliary stenting procedure?

Your pet will be given a general anesthetic. An open surgical approach to the abdomen is necessary to place the biliary stent. The gallbladder and bile duct are directly visualized. A small incision is made into the intestine to access the bile duct. Dye studies are performed to identify the blockage or tumor. Special catheters and devices are used to remove the stone if possible. A stent is then placed to hold the narrowed area open allowing bile to flow more freely.

Risks

Patients may experience both immediate and delayed complications as a result of the procedure. Complications associated with biliary stenting can include the following:

  • Pain
  • Bleeding
  • Fever
  • Nausea and/or vomiting
  • Infection
  • Pancreatitis
  • Recurrent obstruction
  • Stent occlusion
  • Stent migration
  • Excessive scar tissue development

After the procedure

  • Following the procedure, you will be given a phone call with an update on your pet’s recovery.
  • Please plan for your pet to remain hospitalized for pain management, supportive care, and monitoring for 1-3 days post operatively.
  • Once discharged the following instructions are advised:
  • Please remove the bandage from your pet’s intravenous catheter site 10 to 15 minutes after arriving home.
  • Some abdominal tenderness is common for 10-14 days following surgery.
  • It is important to restrict your pet’s activity for the next 14 days while the incision is healing. Walks should be short and your pet should always be on a leash. Please do not let your pet rough house with other animals during this time.
  • There are several sutures that need to be removed in 10-14 days.
  • Please monitor the incision for any signs of excessive heat, pain, swelling, or discharge. Should you notice any of these signs, it may be an indication of infection. Please call Salt River if you notice a problem.
  • Licking or scratching at the incision will dramatically increase the chances of an infection or that the incision will open up. To prevent this from happening, please watch closely for scratching or licking at the incision. I this occurs, an e-collar will be necessary.
  • Post-operative medications and written discharge instructions will be sent home with you.

Follow up

A recheck examination is required 10-14 days following the procedure.