LAUSR

A 59-year-old man underwent orthotopic liver transplantation; liver re-transplantation was needed 24 hours later owing to primary liver failure. A large incisional hernia was repaired 5 years later. Increases in his liver function tests were noted 6 years later and magnetic resonance cholangiography showed an anastomotic biliary stricture. During endoscopic retrograde cholangiopancreatography (ERCP), it was impossible to pass beyond the anastomotic biliary stricture, even with the aid of cholangioscopy (SpyGlass DS; Boston Scientific, Natick, Massachusetts, USA). Percutaneous negotiation of the biliary stricture also failed despite cholangioscopy. After multidisciplinary discussion, surgery was considered too risky owing to the previous E-Videos