Indications and Contraindications

Indications Biliary dilatation resulting from:

■ Benign distal biliary strictures not suitable for transduodenal sphincteroplasty

■ Indeterminate biliary stricture in the head of the pancreas where a preoperative decision has been made not to resect if malignancy cannot be confirmed on exploration and open biopsy

■ Unresectable malignant stricture where the duodenum comfortably reaches the dilated biliary tree

■ Primary or recurrent common duct stones where endoscopic management has failed or is not available

■ Impacted common duct stone

Contraindications

Narrow common bile duct (<8 mm) Active duodenal ulceration

Malignancy when the duodenum does not comfortably reach the dilated bile duct

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