LAUSR

Double-balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) is now an established technique to perform various types of diagnostic and therapeutic interventions in patients with surgically altered upper gastrointestinal anatomy [1]. Herein, we present a novel and simple technique of dual stenting using the stent-pushing-stent technique. A 45-year-old patient who had undergone liver transplant for cirrhosis due to primary sclerosing cholangitis 8 years previously presented with jaundice and cholestasis. Because of primary sclerosing cholangitis, the liver transplant was attached to a jejunal loop (hepaticojejunostomy). Therefore, ERCP had to be performed using DBE. During DBE-ERCP, a tight hepaticojejunostomy stricture was found and classified as type A1 according to Mönkemüller–Jovanovic classification [2]. The stricture was dilated with a 6-mm-diameter controlled radial expansion balloon (▶Video 1). Insertion of plastic stents was indicated to keep the stenosis open and allow for proper fibrotic remodeling around the hepaticojejunostomy, and thus reduce the chances of re-stenosis. E-Videos