Obstructive jaundice can be palliated surgically by choledocho-enterostomy or cholecystenterostomy, although these procedures have been largely superseded by endoscopic and radiological placement of stents. Stents can become blocked, resulting in repeated cholangitis. A recent trial has demonstrated a shorter overall hospital stay and decreased morbidity for surgical palliation of jaundice compared to endoscopic stenting and should be considered in medically fit patients. Selected patients with inoperable hilar tumours will be best treated by segment III biliary enteric bypass.

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