Patients with unresectable pancreatic cancer that produces biliary obs
truction are treated optimally with endoscopically placed endoprosthes
es. Percutaneous biliary drainage is another effective form of palliat
ion, and is indicated when endoscopic palliation is unsuccessful or no
t available. Expandable metal prostheses placed percutaneously are an
effective method of palliating patients with pancreatic cancer and com
mon bile duct obstruction. Internal-external biliary drainage catheter
s also are effective and are preferable with hilar rather than common
bile duct obstruction.