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36 yrs old Egyptian male who was diagnosed with metastatic pancreatic cancer, spreading to the liver, he was presented with obstructive jaundice, and subsequently had underwent ERCP procedure (an endoscopic procedure to evaluate the biliary and pancreatic duct) in Egypt to relieve the main bile duct malignant blockage.
A biliary sphincterotomy (small cut at the bile duct opening ) was made and plastic stent (tube) was placed to bridge the occluded area.
 He was then admitted to the American Hospital Dubai with persistent jaundice and abnormal liver enzymes and recurrent fever and chills.
A repeat ERCP done by Dr. Dahhan, had revealed that the original stent was positioned to drain only portion of the liver. It was elected to be replaced with a permanent covered metal stent, which was positioned in the main bile duct. Subsequently, after few days of observation and antibiotics, his fever , liver enzymes and jaundice showed significant improvement.
 Â Previous studies show that biliary metal stents are considered a beneficial palliative method to decompress malignant biliary structures, with relatively better longevity and less frequency of stents exchange than plastic ones.
Although, metal stents will not alter the survival rate, it might improve quality of life and nutritional status.
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