Figure 2.

After the puncture of the left intrahepatic bile duct (a), a guidewire was advanced through the lower bile duct stricture and the duodenal papilla (b). The dilation of the stricture and the fistula was performed using a 4-mm balloon catheter (c). Radiofrequency ablation to the stricture was performed for 90 seconds at a power of 7 W (d). An uncovered metal stent was placed antegradely across the stricture (e). Finally, a dedicated single-pigtail plastic stent was placed from the hepatic duct to the stomach (f).