AbstractThe problems associated with the establishment of permanent bile drainage in the presence of inoperable bile duct obstructions are discussed, and the possibility of achieving effective drainage by means of an in‐dwelling transhepatic tube is described. Such a tube may be leftin situfor the remainder of the life of patients suffering from carcinoma or indefinitely in patients suffering from nonmalignant obstructions. The techniques involved in the different circumstances are described. Certain special instruments have been made to facilitate introduction of the tube, and a description of these instruments and their use is given. A few representative case histories are given in which the various procedures were employe