Aims: Placement of biliary self expandable metal stents (SEMS) in patients with pancreatic carcinoma suitable of surgical treatment has been controversial. Since covered SEMS (SEMSc) became available, the possibility of inserting these stents in potentially surgical patients is safer as they can be removed if necessary in 85-95% of cases. The aim of this study is to assess the effectiveness and safety of SEMSc in patients with malignant jaundice secondary to border-line resectable pancreatic carcinoma. Material and Method: 33 consecutive patients (23 m/10f; age 69.1 yrs) with obstructive jaundice secondary to border-line resectable pancreatic carcinoma (superior mesenteric vein invasion,large tumor, retroperitoneal growth) were included in the study. After biliary drainage with a SEMSc,patients underwent neoadjuvant treatment with gemcitabin and radiotherapy during 8 weeks. Patients were reevaluated after treatment by CT scan and tumors staged as unresectable or potentially resectable. In those patients harbouring potentially resectable tumors surgery was indicated. Effectiveness in jaundice palliation, accomplishment of neoadjuvant therapy and stent removal requirements during presurgical period were assessed. Stent related postsurgical complications were also evaluated. Results: SEMSc could be inserted in all patients although in one case the stent had to be removed 72 hours after placement due to acute cholecystitis (3%). 32 patients completed oncologic treatment with no toxicity related to the stent. After CT reevaluation,21 patients (65.6%) were considered unsuitable for surgery and 11 patients (34.4%) candidates for tumor resection. Bilirubin levels dropped from 15.3 to 1.1 mg/dl (p < 0.01) in surgical patients with no episodes of cholangitis. In 4 of the 11 patients stent removal was indicated prior to surgery to assure bilioenteric anastomosis. It was successfully performed in all patients with a polypectomy snare after a mean post insertion period of 11.5 weeks. At operation,4 patients were not resected due to peritoneal disease and 7 patients finally resected (21.9%). Cholangitis pathological features were present in all surgical specimens but clinical cholangitis or anastomotic fistula were not registered during postoperative follow up in any patient. Conclusions: 1. SEMSc are effective in presurgical jaundice palliation in patients with border-line resectable pancreatic carcinoma. 2. These stents allow neoadjuvant oncologic treatment accomplishment without any added toxicity. 3. The possibility of stent removal when needed is a remarkable advantage in terms of safety. 4. Postoperative complications do not increase in relation to presurgical SEMSc insertion.