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
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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