Patients with malignant obstructive jaundice were treated by converting percutaneous transhepatic cholangio-drainage (PTCD) to internal drainage, using a new apparatus and technique. All patients had unresectable neoplasms. This procedure was devised because of the disadvantages of permanent percutaneous external drainage, and it was indicated when palliative surgical drainage was unsuccessful. No severe complications were encountered, except for cholangitis in 2 cases. Many patients remained stable during several months of close clinical monitoring as outpatients. We concluded that nonsurgical diversion of PTCD to internal drainage is safe and effective for palliative decompression of bile ducts in patients with inoperable malignant obstructive jaundice.