Inclusion Criteria:

- pt more than 20yrs.

- BD stenosis at least 2cm distal of the hepatic hilum, with typical malignant exposure
radiologically.

- Clinically in accordance with tumour.s-bilirubin more than 50 micromol per litre.

- Radical surgery probably not possible(temporary-1month-plastic stenting for further
investigation and then exchange to SEMS if estimated non-operable, after Rx is
allowed).

- The patient must be fully informed by his doctor orally and in writing prior to the
procedure, and give her/his informed consent. Ultrasound or CT examination must be
performed prior to Rx.

Exclusion Criteria:

- Informed consent not obtained.

- Significant multiple intrahepatic stenosis by multiple tumour growth, not suitable
for ERCP stenting.

- Radical Surgery will probably take place. Suspicion of non-malignant
obstruction-further investigation must be performed.

- Not possible by anatomical reasons to reach the papilla, i.e because of prior
operations.

prior BD stent inserted (metal stent or plastic stent >1month).

- Previously included in this trial. Prothrombin index more than 1.5. (normal <1.1).