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Although endoscopic biliary drainage(ERBD) is the preferred palliative treatment for unresectable malignant obstructive jaundice, the failure of endoprosthesis insertion occurs in 15% of the cases. In most cases, technical failure results from the inability to pass either a guide wire or a stent beyond the bile duct stricture due to high grade biliary stenosis or tumorous extending down to involve the papilia so that no normal orifice can be identified. In instances of technical failure, percutaneous transhepatic biliary drainage (PTBD) can be achieved, but compared to ERBD, prolonged external decompression has important disadvantages, and the placement of large-bore endoprothetic stent is painful, requires a bougination, and has fairly high complication rate. Recently, percutaneous endoscopic biliary stent (PEBS) is more commonly used in these patients because of higher successfulness than ERBD and higher safety than PTBD. So we report a case that was performed PEBS successfully, previously failed ERBD due to high grade stenosis of extrahepatic bile duct resulting from cholangiocarcinoma.
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