Medical Oncologist
CION Cancer Clinics
Plastic stent or metal stent: what decides the choice | CION Cancer Clinics
The main question is whether the tumour might still be removed by an operation. If surgery is possible or undecided, a plastic or removable stent usually comes first. If surgery is ruled out, a metal stent is often chosen because it tends to stay open longer. This page explains both types, how the team decides, and what to ask before the procedure. At CION Cancer Clinics in Hyderabad, our oncologists explain liver cancer in plain words and plan care around you and your family.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- Should my father get a plastic stent or a metal stent?
- How are plastic and metal stents different?
- What questions does the team ask before choosing a stent?
- Plastic or metal: how do they compare in practice?
- What do families often get wrong about stents?
- What this page cannot tell you
- Common questions about plastic and metal stents
The short answer
Should my father get a plastic stent or a metal stent?
It depends mostly on one question: could the tumour still be removed by an operation? If surgery is still possible, or nobody knows yet, a plastic stent or a removable covered metal stent is usually chosen first. If the team is sure surgery is not an option, a metal stent is often preferred, because it tends to stay open for longer.
What a stent actually does
A bile duct cancer can squeeze the tube that carries bile from the liver to the gut. Bile backs up, and the skin and eyes turn yellow. A stent is a small tube placed inside the narrowed duct to hold it open, so bile can drain again. Our page on why a stent comes before any cancer treatment explains why this is often the first step.
Who this page is for
It is written for families facing bile duct cancer, either near the top where the ducts join (perihilar) or lower down near the pancreas (distal). If the blockage is from pancreatic cancer, the pancreatic stent page fits better. Stones and benign narrowing follow different rules.
The choice is a team decision. It is fine to ask which stent is planned, and why, before the procedure.The two kinds
How are plastic and metal stents different?
Both do the same job. They differ in width, how long they usually last, and whether they can be taken out again.
Plastic stent
A narrow, straight or slightly curved tube. It is cheaper and easy to remove or swap during a later procedure.
Things to know
- Tends to clog sooner, as bile sludge builds up inside
- Often changed on a planned schedule
- Leaves the duct easy for a surgeon to work on
Uncovered metal stent
A fine metal mesh that opens out to a much wider tube once it is in place. Its wider channel usually keeps bile flowing for longer.
Things to know
- Tissue grows into the mesh, so it is usually permanent
- Costs more on the day it is placed
- Can still block, from tumour growing through the mesh
Covered metal stent
A metal stent wrapped in a thin coating that stops tissue growing through. Because of that coating it can often be removed later.
It can slip out of place more easily, and it is not suitable for every position in the duct.The one point families miss
A longer-lasting stent is not always the better stent. If an operation may still happen, the easy-to-remove option often protects that chance.
Not sure whether this applies to you?
Ask an oncologistHow the team decides
What questions does the team ask before choosing a stent?
Is the diagnosis confirmed?
Often a brushing or tissue sample is taken during the same ERCP, a camera procedure passed through the mouth into the bile duct. Until cancer is confirmed, most teams avoid a permanent metal stent.
Could surgery still be possible?
The tumour board reviews the scans, ideally before the stent goes in. A stent can blur later pictures, so the scan comes first wherever it safely can.
Where exactly is the narrowing?
Low blockages near the pancreas are simpler to stent. Blockages high up, where the left and right ducts join, may need more than one stent, or a drain through the skin instead.
How long will drainage be needed?
If chemotherapy is planned for a long stretch, fewer blockages and fewer repeat procedures matter more. For a short wait before surgery, a plastic stent is often enough.
What can the family manage?
Travel from a district for repeat stent changes, and the upfront cost, are fair things to raise. The team should hear them.
Side by side
Plastic or metal: how do they compare in practice?
Plastic stent
Metal stent
Lower cost on the day
Higher cost on the day, fewer repeat procedures later
Usually blocks sooner and needs changing
Usually stays open for longer
Easy to remove or replace
Uncovered ones are normally permanent
Often chosen while surgery is still possible
Often chosen when surgery is ruled out
Blockage is fixed by swapping the stent
Blockage is fixed by placing a stent inside the stent
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Commonly believed
What do families often get wrong about stents?
"The expensive metal stent is always the better one."
It lasts longer on average, but it can make a later operation harder. When surgery is still being considered, the cheaper plastic stent is often the right choice, not a cut corner.
"Once the stent is in, the cancer is being treated."
A stent only lets bile drain. It does nothing to the tumour itself. It clears the jaundice so that real treatment, such as surgery or chemotherapy, becomes safe to start.
"If the stent blocks, the doctors chose wrongly."
Every stent can block in time. Bile sludge, debris or tumour growth are the usual reasons. A blockage is expected and fixable, which is why you are told which warning signs to watch for.
"A metal stent will set off alarms or rule out scans."
Biliary stents are small and usually do not stop you having CT scans. Tell every scan centre you have a stent before an MRI, so they can check the type.
Being straight with you
What this page cannot tell you
It cannot tell you which stent suits your family member. That choice rests on the scans, the exact position of the narrowing, whether the cancer is confirmed and whether an operation is still on the table. The specialist who places the stent and the tumour board decide it together.
Who does what
At CION, the oncology team and tumour board review the case and plan the order of events. ERCP and drains placed through the skin are done by gastroenterologists and interventional radiologists at accredited partner hospitals, which CION coordinates. Your team will tell you where the procedure takes place. For a drain through the skin, see percutaneous biliary drainage.
Who this does not apply to
Stents for gallstones, benign narrowing after surgery or primary sclerosing cholangitis follow different rules. Gallbladder cancer has its own separate section. Cost depends on the stent type and the hospital, so ask for a written, itemised estimate before the day.
If you already have a stent and develop fever, shivering or returning jaundice, read the page on blocked stents and fever and act the same day.Questions we are asked
Common questions about plastic and metal stents
How long does a plastic stent last?
It varies from person to person. Plastic stents tend to clog sooner than metal ones, which is why many teams plan to change them on a schedule rather than waiting for a blockage. Ask your team when the next change is planned, and write the date down.
Can a plastic stent be changed to a metal one later?
Yes, this is common. A plastic stent is often placed first while tests and the surgery decision are pending. Once the team knows an operation is not possible, they may swap it for a metal stent during a later ERCP to reduce repeat procedures.
Can a metal stent be removed?
A covered metal stent can often be removed, because tissue does not grow through its coating. An uncovered metal stent usually cannot, since tissue grows into the mesh and holds it in place. Ask which kind you have and keep the procedure report.
Does a stent hurt once it is in?
Most people do not feel the stent at all. Some have mild discomfort in the upper abdomen for a day or two after the procedure. New or severe pain, fever or vomiting is not normal and needs a doctor the same day.
Will I need more than one stent?
Sometimes. A tumour high up where the left and right ducts meet can block both sides, and draining more than one part of the liver may need two stents or a drain through the skin. Low blockages near the pancreas usually need only one.
Can chemotherapy start once the stent is in?
Usually only once the jaundice has settled and blood tests show the liver is clearing bile again. Many chemotherapy medicines are handled by the liver. See systemic treatment for biliary cancer for what comes next.
Is a metal stent worth the extra cost?
When surgery is ruled out and drainage is needed for a long stretch, fewer repeat procedures and hospital trips can make it worthwhile. When surgery is still possible, it may not be. Ask for a written estimate for each option before deciding.
Who should we ask if we are unsure?
Ask the specialist who will place the stent, and ask your oncologist whether surgery has been fully considered. If you want a second opinion before the procedure, call the CION helpline and someone will arrange a review of the scans.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- American Cancer Society — Palliative Therapy for Bile Duct Cancer
- Cancer Research UK — Treatment for bile duct cancer
- National Cancer Institute — Bile Duct Cancer Treatment
- Macmillan Cancer Support — Bile duct cancer (cholangiocarcinoma)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Why a stent comes before any cancer treatmentWhy drainage is the first step at allBlocked stents, fever and when to come back urgentlyThe warning signs once a stent is inMRCP, ERCP and cholangioscopy explainedThe procedure used to place most stentsBiliary stent vs surgical bypassWhen an operation drains bile instead
Talk to us
Not sure the right stent has been planned?
Send us the scans and reports and a CION oncologist will look at whether surgery has been fully considered before a stent is chosen. One helpline serves every CION centre.