Several palliative operations are performed for obstructive jaundice caused by an unresectable malignant tumor in the region of the head of the pancreas, duodenum, and hepatic duct. These procedures are not ideal as there are losses of bile in the external drainage, obstruction of the anastomosis by tumor invasion and ascending biliary tract infection in cases of internal drainage. Failure of sutures is lethal in these poor risk patients. Choledochojejunorrhaphy plus the application of an internal T-tube splint of silicone rubber should keep the drainage patent for a longer period.