In 30 patients with inflammatory bile duct stenoses or slow-growing tumors of bile ducts, 12-18 F silicone catheters were placed with a percutaneous transhepatic approach in order to provide a more efficient and comfortable internal-external drainage. The main advantages were the large variety in size, improved flow, and softness of the catheter. However, because of the absence of distal tapering, the tubes had to be inserted several days after the initial drainage, when a tract was formed through the liver.