Use of the Portner-Koolpe biliary biopsy catheter to facilitate double-guide-wire placement

Percutaneous transhepatic changing of an endoscopically placed stent

Biliary stents are commonly positioned for the relief of obstructive jaundice secondary to malignancy. It is occasionally necessary to percutaneously replace a biliary stent placed by the endoscopist. This is usually because there has been progression of the tumour, which has prevented further endoscopic access. The technique described has real merit since it can further extend palliation.