Metallic Stents in Malignant and Benign Biliary Obstruction: Retrospective Long-Term Results of Occlusion Rate, Complications and Reinterventions Introduction: The aim of this study was to analyze the occlusion of percutaneously inserted metallic stents in malignant biliary obstruction and to evaluate all complications associated with the stents and reinterventions needed. Patients and Methods: 85 patients with 79 malignant and 6 benign strictures were treated percutaneously with 121 metallic stents. 112 were wallstents and 7 were Palmaz stents. 41 of the malignant stenoses were hilar, 26 biliary ductal and 7 proximal and distal strictures. In 5 cases strictures were in the hepaticojejunal anastomosis. The patients with malignant strictures were followed until death, and the mean follow-up was 15.9 months. Results: Stent insertion was successful in 99.2% of the patients. 25.8% had low and 2.3% heavy complications. A cholangitis was seen in 80.5% and a pancreatitis in 49.2%. A transpapillary stent position is not connected with a higher rate of pancreatitis. An early clinical success was demonstrated in 56.2% (<30 days). An inadequate tumor-stent distance is connected with more frequent complications, an elevated occlusion rate as well as more reinterventions and comes along with a lower survival rate. In 18.8% of patients a reintervention was made. Taking into account all patients with an increase of bilirubin, the reocclusion rate was 40%. Discussion: Metallic stents offer an alternative in the palliation of malignant bile duct obstructions even though the rate of early and late complications is not negligible.