Relief of bileduct obstruction by the percutaneous transhepatic insertion of an endoprosthesis

Benign and malignant biliary strictures can be treated by the percutaneous transhepatic insertion of an endoprosthesis. We report the use of this technique in 44 patients, with a detailed description of the procedure. Insertion was successful in 41, three of whom later had elective surgery, and one, emergency laparotomy for biliary peritonitis. This patient died post-operatively. Cholestasis was relieved in 31 of the remaining 37 patients. Complications occurred in four. Twelve patients, all with malignant disease, died within 30 days of the procedure. The percutaneous insertion of a biliary endoprosthesis is a valuable alternative to surgery in selected patients. Complications can occur, and the prognosis depends on the nature of the underlying disease.