Abstract
AbstractSeveral endoscopic methods have potential value in the management of patients with biliary obstruction due to malignant disease. Jaundice can be relieved either as definitive palliation, or as preparation for surgery, by endoscopie placement of indwelling prostheses, or by sphincterotomy of tumors at the papilla of Vater. Blockage of prostheses remains a problem in some patients who survive for more than a few months, and improvements in materials are anticipated. Late duodenal obstruction is surprisingly uncommon. These techniques are valuable in many elderly and frail patients. The results of ongoing randomized trials will help define indications for their use in other contexts and for their roles relative to surgery and percutaneous methods.
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