1.   Also, surgical morbidity related to biliary drainage remains high in these alcoholic and often debilitated patients.

2.   Our opinion at that time was that permanent endoscopic biliary drainage in CP should be reserved for patients whose poor clinical condition made an operation unsuitable.

3.   First, prompt biliary drainage is established in the obstructed duct and second, subsequent impactation of stones is prevented by the presence of the endoprosthesis within the duct.

4.   The insertion of an endoprosthesis was successful in establishing adequate biliary drainage in all the patients.

5.   In one patient in whom there appeared to be delay in biliary drainage at endoscopic retrograde cholangiopancreatography, an endoscopic sphincterotomy was performed.

6.   Although occasional patients with evidence of biliary outflow obstruction due to ampullary stenosis have been described, we saw only one patient in this study with delayed biliary drainage.

7.   After a period of external biliary drainage the guide wire was reinserted and advanced through the stricture to allow insertion of an endoprosthesis.