[Bile duct endoprostheses in tumor disease: when is the expense justified?]

Percutaneous transhepatic catheters should be reserved for the minority of palliatively treated tumor patients because of the chronic complications and the discomfort to the patients. Plastic biliary endoprostheses relief malignant obstructive jaundice in most patients sufficiently. Late complications such as occlusion and displacement occur relatively often. The major advantages of expandable metal stents are the relative ease and the low rate of complications during the insertion procedure. The wide lumen and the small surface ensure good flow of bile and reduce the risk of occlusion and cholangitis. However, further development is necessary and the very expensive devices should be restricted to those patients with long life expectancy.