This 65 year old gentleman had undergone living donor liver transplant two years ago. He had recently developed pruritus. His MRCP showed dilated intrahepatic biliary channels proximal to the strictured anastomotic site (A: red arrows show the dilated intrahepatic bile ducts and white arrows indicates the narrowed anastomotic segment). Due injection confirmed the MRCP findings (B: black arrow marks the stricture site). The stricture was dilated using a 7-8.5-10 French graduated dilatation catheter (C:black arrows show the catheter traversing the stricture). A stent assembly was then passed ahead. We had to do a bit of pulling and straightening (D1, D2 & D3: red arrows mark the stent assembly and the black arrow shows the kink that we had to "iron out". The white arrow in D3 shows the stent going up a straight assembly). A 10 French plastic stent of 12 cm length was deployed (E & F: white arrows show the deployed stent).
I am a gastroenterologist. This is a blog of the ERCPs and related endoscopic procedures carried out at my department. Dr Adnan Salim.
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