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Metastatic pancreatic cancer (patient with history of Roux-en-Y gastric bypass surgery). (A) Dilated left intrahepatic biliary radicle; (B) Needle puncture of left intrahepatic biliary radicle using a 19-gauge needle; (C) Cholangiogram showing dilated intrahepatics, proximal and mid-common bile duct; (D,E) Left-sided hepaticogastrostomy.
