Drainage of a malignant common hepatic duct obstruction by a biliary endoprosthesis placed through a T-tube tract:...

For patients with high biliary obstruction drained by a T-tube, achieving internal drainage requires special techniques. Modification of a method described by Sammon for common bile duct obstruction permits placement of a biliary endoprosthesis astride the T-tube tract. The key step is traction exerted downward on the endoprosthesis by a suture passing through a second catheter temporarily inserted into the common bile duct. A case is described in which the technique has been applied successfully.