This 70 year old gentleman had a gall bladder mass with involvement of the porta hepatis and duodenum. The ampulla was fairly normal looking when we went in (A:green arrow), though maneuvering into the descending duodenum was a bit tricky. Contrast injection outlined a stricture in the proximal bile duct (B: green arrow) with pre-stenotic dilatation of intrahepatic channels. A self expanding metallic stent assembly was placed across the stricture (C: green arrow) and a 10 cm long stent of 10mm diameter was deployed (D: green arrows and E: green arrow).
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