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Endoscopic palliation of malignant obstructive jaundice.

Patients referred for endoscopic retrograde cholangiopancreatography (ERCP) over a 12 month period who had a diagnosis of malignant obstructive jaundice prior to or confirmed by the procedure were reviewed. Insertion of a biliary endoprosthesis was attempted in 23 out of 26 patients and was successful in 19 (82%). A significant fall in bilirubin was seen in 15 (79%) of those who had a successful procedure. The only early complication was cholangitis in two patients. Late complications were related to occlusion of the endoprosthesis and replacement was required in six patients. Endoscopic palliation of malignant obstructive jaundice is a useful technique and should be considered as the initial procedure in all patients considered to have nonresectable malignancy.