摘要：Background: Although endoscopic palliation of malignant biliary hilar obstruction is preferable to surgery or percutaneous drainage, it remains technically challenging. This is especially true when multiple self-expanding metal stents (SEMS) are pl.c.d, because difficulty is commonly encountered in passing the second SEMS at the level of the previously deployed initial stent. We have devised a method of deploying multiple metal stents by using a temporary plastic stent, which makes deployment of the second stent much easier. Methods: After guidewire pl.c.ment, a plastic stent is deployed in a subhilar position. The initial SEMS is deployed, with the plastic stent maintaining a passage for the second SEMS. After the second SEMS is deployed, the plastic stent is retrieved. Observations: This technique has been used successfully in 7/8 patients, all of whom presented with symptomatic jaundice secondary to malignant hilar obstruction of various etiologies (cholangio-carcinoma, n = 4; metastatic disease, n = 3; and hepatocellular carcinoma, n = 1). Drainage was successful in all.c.ses, with significant improvement in symptoms and cholestasis. conclusions: This simple technique lessens the technical difficulty of pl.c.ng bilateral hilar SEMS.