Peroral radiographic placement of biliary stents

The authors describe a modification of peroral-transhepatic placement of biliary stents for patients with malignant biliary obstruction. A stent is "pulled" into place perorally. The procedure can be performed with simple, readily available commercial materials. An endoscopist is not required. This method is cost-effective, less cumbersome, and easier to perform than the standard methods. In the authors' four cases, this modified approach appears equally effective.