摘要：Backgro.nd: Altho.gh endo.co.ic palliatio. o. malignant biliary hilar o.structio. is preferable to.surgery o. percutaneo.s drainage, it remains technically challenging. This is especially true when multiple self-expanding metal stents (SEMS) are placed, because difficulty is co.mo.ly enco.ntered in passing the seco.d SEMS at the level o. the previo.sly deplo.ed initial stent. We have devised a metho. o. deplo.ing multiple metal stents by using a tempo.ary plastic stent, which makes deplo.ment o. the seco.d stent much easier. Metho.s: After guidewire placement, a plastic stent is deplo.ed in a subhilar po.itio.. The initial SEMS is deplo.ed, with the plastic stent maintaining a passage fo. the seco.d SEMS. After the seco.d SEMS is deplo.ed, the plastic stent is retrieved. o.servatio.s: This technique has been used successfully in 7/8 patients, all o. who. presented with sympto.atic jaundice seco.dary to.malignant hilar o.structio. o. vario.s etio.o.ies (cho.angio.carcino.a, n = 4; metastatic disease, n = 3; and hepato.ellular carcino.a, n = 1). Drainage was successful in all cases, with significant impro.ement in sympto.s and cho.0}stasis. Co.clusio.s: This simple technique lessens the technical difficulty o. placing bilateral hilar SEMS.