Biliary endoprosthesis secured by a subcutaneous button to prevent dislocation

Decompression of both benign and malignant bihiary obstructions can be achieved nonsurgically by transhepatic insertion of endoprostheses [1 -4]. The method may be used for temporary drainage in resectable lesions or for permanent internal drainage in inoperative lesions [1 , 3, 4]. Dislocation of the endoprosthesis causing malfunction occurs in 4% [3, 4] to 40% [2] of the patients, mostly in those with short or angulated strictures high in the hihum of the liver. We have devised a new method for prevention of dislocation of endoprostheses. By a nylon suture sewn on the proximal end of the endoprosthesis and anchored to a subcutaneously-placed silicone button, the endoprosthesis is securely fixed.