It is standard practice to leave a temporary external catheter in plac
e for 24-48 h after biliary Wallstent placement. We aimed to establish
the safety and effectiveness of a true single-stage procedure. Twenty
-two patients underwent Wallstent insertion for palliation of malignan
t obstruction of the biliary tract. Following percutaneous cholangiogr
aphy and balloon dilatation of the stricture, 10 mm Wallstent endopros
theses were inserted extending from the upper common hepatic duct to t
he duodenum. The introducer was then exchanged for a catheter and a ch
olangiogram performed. In 11 cases the catheter was removed, in the re
maining cases it was not removed until after a satisfactory cholangiog
ram at 24-48 h. All of the patients from whom the catheter was removed
made a good recovery with no procedure-related complications; in part
icular no early stent obstruction or leakage of bile was observed. Rig
ht flank pain was minimized and mobilization accelerated by the absenc
e of an external catheter. We feel that true single-stage percutaneous
introduction of Wallstent biliary endoprostheses is safe and effectiv
e in patients with lesions in the common bile duct.