To avoid potential complications of prolonged stenting, including stent migration and occlusion causing pain, cholangitis, and obstructive jaundice, biliary stents are to be removed within 4-6 weeks of placement. An endoscopist who places a temporary stent in this situation is considered to have “ownership” of it until it is removed, or it is shown to have passed spontaneously by either appearing in the patient’s stool, or being shown to no longer be present on abdominal imaging. In the event of a patient appearing to ignore instructions to return for stent removal, which should always be provided in writing in the discharge instructions, gastroenterologists need to be proactive to ensure it is done. This is often achieved by sending the patient a registered letter and/or contacting the patient’s primary care provider to intervene. Regardless of the exact method chosen, it is not acceptable to assume that patients will follow up as requested: they may not appreciate the importance of having the second procedure.
Biliary stent removal medical expert witness specialties include gastroenterology, hepatology, general surgery, hepatobiliary surgery, transplant hepatology, and transplant surgery.