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Plastic or metal bile duct stent: how the choice is made | CION Cancer Clinics
Neither stent is better for everyone. A metal biliary stent usually stays open longer and needs replacing less often. A plastic stent costs less, is easy to remove, and suits a short gap before surgery or while a diagnosis is confirmed. This page explains how the two differ, which situations lean towards each, and what to ask your team before one is placed. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Is a plastic or a metal bile duct stent better?
- How do plastic and metal stents differ?
- Which situations lean towards each stent?
- How is a bile duct stent put in?
- What do families often get wrong about stents?
- What should you ask before the stent is chosen?
- Common questions about plastic and metal bile duct stents
The short answer
Is a plastic or a metal bile duct stent better?
Neither is better for everyone. A metal stent usually stays open for longer and needs changing less often. A plastic stent costs less, is easy to take out, and suits a short gap, such as the weeks before an operation or while a diagnosis is still being confirmed.
What both stents are for
Bile is the green-brown fluid the liver makes to help digest food. It drains down a narrow tube, the bile duct, into the gut. A cancer of the pancreas, bile duct, gallbladder or nearby lymph nodes can squeeze that tube shut. Bile then backs up into the blood. The skin and eyes turn yellow, urine goes dark, and the itching can keep a person awake all night. A stent is a small tube placed inside the narrowed duct to hold it open, so the bile can flow again.
Why the choice matters to your family
A blocked stent brings the yellowing back, often with fever. Each blockage means another procedure and sometimes a hospital stay. So the real question is how long the stent needs to work, and whether the duct may later be removed in an operation. Your team weighs those two things before choosing.
This page explains the choice. It cannot tell you which stent suits your own scan and plan.Side by side
How do plastic and metal stents differ?
Plastic stent
Metal stent
A narrow, stiff tube of fixed width
A folded mesh tube that opens out wider once in place
Tends to clog with bile sludge sooner
Usually stays open for longer
Often changed on a planned date
Often left in place for as long as it keeps working
Simple to remove or swap
Some types can be removed; many are meant to stay
Lower price for each stent
Higher price, but may mean fewer repeat procedures
Matching stent to situation
Which situations lean towards each stent?
These are the patterns teams usually follow. Your own plan may differ for good reasons.
Diagnosis not yet confirmed
When a biopsy result is still awaited, a plastic stent is often placed first. It relieves the yellowing now and keeps every later option open.
Surgery is planned soon
Many people go straight to surgery without any stent. If one is needed because the yellowing is severe or chemotherapy comes first, the team chooses a type the surgeon is happy to work around.
Ask your surgeon which type they prefer and why.The duct will not be operated on
When the tumour cannot be removed, the stent may need to work for many months. A metal stent is often chosen here, because fewer blockages mean fewer trips back to hospital.
When neither suits
Some blockages sit too high in the liver, or the scope cannot reach the duct.
Other routes the team may discuss
- A drain placed through the skin into the liver
- A bypass operation joining the duct to the gut
Not sure whether this applies to you?
Ask an oncologistOn the day
How is a bile duct stent put in?
Before the procedure
You will be asked not to eat for some hours beforehand. Blood tests check clotting and liver function. Tell the team about any blood thinner, such as clopidogrel or warfarin, and let them decide what to do with it.
The scope
Most stents go in through an ERCP. A thin, bendy camera tube passes through the mouth, down to where the bile duct opens into the gut. You are sedated or given anaesthesia, so you will not feel it go down.
Placing the stent
A fine wire is guided through the narrowing using X-ray pictures. The stent slides over the wire into position. Bile often starts draining straight away.
Afterwards
You are watched for pain, fever and bleeding. Many people go home the same day or the next. The yellowing and itching usually fade over the following weeks.
!
Signs the stent may have blocked
A fever with shivering, new yellowing of the eyes, dark urine, or pain in the upper right side of the belly can mean the stent has blocked and the bile has become infected. This needs care the same day. Go to the nearest emergency department, say the person has a bile duct stent, and carry the ERCP report with you. Do not wait to see whether paracetamol settles the fever first.
Commonly believed
What do families often get wrong about stents?
"Metal is the more expensive stent, so it must be the better one."
Price reflects how the stent is made. A metal stent can be the wrong choice before some operations, and a plastic stent can be exactly right for a short gap. The team chooses by the plan, not the price tag.
"Once the stent is in, the cancer is being treated."
The stent only opens the duct so bile can drain. It does nothing to the tumour itself. Surgery, chemotherapy or radiotherapy are separate decisions, and the stent often makes them safer to start.
"The yellowing came back, so the stent was put in badly."
Stents clog with sludge over time, and a tumour can grow into or around one. That happens even when the placement was done well. It usually means the stent needs clearing or replacing.
"We should wait for the itching to settle before calling anyone."
Itching alone can wait for the next clinic visit. Itching with fever, shivering or fresh yellowing cannot. Those together point to a blocked, infected duct.
Being straight with you
What should you ask before the stent is chosen?
The most useful question is simple. How long does this stent need to work, and is an operation on the bile duct still possible? The answer to those two points drives almost everything else.
Questions worth taking to the appointment
Ask whether the biopsy result is final. Ask whether surgery is still on the table, and whether the surgeon has seen the scans. Ask what happens if the stent blocks at night or on a weekend, and which hospital to go to. Ask how the stent will be checked and when.
What the page cannot tell you
A stent type says nothing about how the cancer will behave. It is not a sign that the team has given up on treatment, and it is not a measure of how serious things are. How long any stent stays open also varies widely from person to person.
About the cost
A metal stent costs more than a plastic one. Aarogyasri, CGHS, ECHS, EHS and cashless insurance often cover stenting as part of cancer care, so the amount you pay yourself can be very different from the list price. Ask for an estimate against your own cover.
Questions we are asked
Common questions about plastic and metal bile duct stents
How long does a plastic bile stent last?
It varies a great deal. Plastic stents clog with sludge sooner than metal ones, so many teams plan to change them on a set date rather than wait for trouble. Your gastroenterologist will tell you when to come back. Write that date down and keep it, even if you feel well.
Can a metal stent be taken out later?
Some can. Covered metal stents, which have a thin lining over the mesh, can often be removed. Uncovered ones grow into the duct wall and are usually meant to stay for good. If removal may matter to your plan, ask which type is being used before the procedure.
Will the stent stop the itching and the yellow colour?
In most people, yes, once bile drains again. Itching often eases within days. The yellow colour of the skin and eyes takes longer to fade, usually over a few weeks. If it is not improving, or is getting worse, tell your team, because the stent may not be draining properly.
Does a metal stent get in the way of surgery?
It can, depending on its length and where it sits. Surgeons have different preferences. This is why the surgeon should ideally see the scans before any stent is placed when an operation is a possibility. Ask the gastroenterologist whether they have spoken to the surgical team.
Can I eat normally with a bile duct stent?
Yes. The stent sits inside the bile duct, not in the food pipe, so it does not limit what you swallow. As bile flows again, appetite and digestion of fatty food often improve. A dietitian can help if weight has dropped during the weeks of yellowing.
What are the risks of putting the stent in?
The main ones are inflammation of the pancreas, bleeding, infection, and rarely a small tear in the gut wall. Most people have none of these. Your doctor will explain how the risks apply to you before you sign the consent form. Ask what signs to watch for at home.
Can I have chemotherapy with a stent in place?
Yes, and the stent is often what makes chemotherapy possible, because some drugs are unsafe when bile is backed up. A fever during chemotherapy with a stent in place needs quick attention, since it could be a low white cell count or a blocked stent. Call your team the same day.
Is stenting covered by Aarogyasri or insurance?
Often it is, when it forms part of a cancer treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. Cover for the stent itself can vary by type. Call the helpline with your card details and we will check what applies to you.
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Sources
- National Cancer Institute — Pancreatic Cancer Treatment (PDQ), Patient Version
- National Cancer Institute — Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ), Patient Version
- Cancer Research UK — Bile duct cancer
- NHS — Jaundice
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.
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