Many kinds of biliary stents have been used to maintain patency of a bile duct which is obstructed by benign stricture or tumor. However, the biliary stents in current use have a tendency to block. The long term functioning of biliary stents is limited by clogging. In order to maintain a long term stent patency before clogging, larger diamenter of biliary stents is needed and some kinds of expandable stents such as Strecker stent, Wallstent or Z-stent are proposed. Gianturco-Rosch Z-stent is of a modified Gianturco design and is a new self-expanding stainless steel stent for d ainage of obstructed bi liary system. It is a cylindrical wire structure made of stainless steel wire which is bend in a zigzag pattern. There are several theoretical advantages of the stainless steel stent over conventional stents. Because it not only has low mass and a small surface area but also tends to become buried into the wall of the bile duct, this should decrease the likelihood of infection, which is the most common cause of obstruction of conventional stents. It also provides a structural support for the bile duct, which is particularly important in benign strictures. The place- ment of numerous stents through a single access should allow more effective therapy in patients with malignant obstruction of multiple systems.
It was initially designed for percutaneous transhepatic placement, and has been used only for a percutaneous transhepatic technique. Nowadays these stents for endoscopic application were introduced. Now we describe a new method for endoscopic retrograde placement of Gianturco-Rosch biliary Z-stent in a patient with a benign stricture and multiple gall stones of common bile duct.