Large-bore, long biliary endoprostheses (biliary stents) for improved drainage.

Seventy-one large-bore, long biliary stents were placed in 62 patients. The 12-Fr Teflon stents with multiple side holes were made to extend from the entrance point of the biliary tree to the wall of the duodenum opposite the ampulla of Vater. The entire procedure takes one week. The techniques for placement and proper fashioning of the stents are described in detail. In one patient, the biliary tree was re-entered 15 months after the initial placement of a stent. The stent was removed percutaneously and replaced by a longer stent. The technique for removal is also described. The problems of migration and obstruction have been overcome with this technique, making this the preferred method of nonsurgical drainage of malignant obstructive jaundice.