Endoscopic management of malignant biliary obstruction and recurrent cholangitis with a self-expanding prosthesis

Endoscopic implantation of a prosthesis usually provides effective palliation in malignant biliary obstruction and in some cases of benign strictures. The most common problem concerning stent patency is occlusion, which may lead on to cholangitis and septic complications. A new technique employing self-expanding stents offers encouraging results. Preliminary clinical experience with expanding biliary stents are reported. The expectations of the doctor and patient, and the preferences and advantages of this new method are discussed on the basis of a case report with recurrent septic complications caused by conventional biliary prosthesis.