ENDOSCOPIC TREATMENT FOR benign biliary strictures is widely performed because it is safe and repeatable. However, the stent for benign biliary strictures sometimes migrates due to the slippery bile duct. To solve the problem, we placed a unilateral pigtail stent named the “through-the-mesh” (TTM) stent (Fig. 1) above the papilla. A 66-year-old female was referred to our hospital for biliary stricture and obstructive jaundice as an adverse event after living donor liver transplantation for hepatocellular carcinoma. We performed endoscopic retrograde cholangiography (ERC) which revealed the duct-to-duct anastomotic stricture (Fig. 2a). As the first treatment, we had placed a plastic inside stent with a proximal flap (8.5 Fr, 9cm length) to bridge the stricture. After 3 months, we attempted stent exchange, however, the stent removal was difficult due to tight anchoring of the flap. To make stent exchange easier, we placed a shortened flap or a proximal

中文翻译：

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在乳头上方放置远端猪尾形支架治疗胆道梗阻的可行性

良性胆道狭窄的内镜治疗因其安全且可重复而被广泛使用。然而，良性胆管狭窄的支架有时会因胆管滑溜而移动。为了解决这个问题，我们在乳头上方放置了一个名为“穿网孔”（TTM）支架（图 1）的单侧猪尾支架。一名 66 岁女性因肝细胞癌活体肝移植术后出现胆道狭窄和梗阻性黄疸而被转诊至我院。我们进行了内窥镜逆行胆管造影（ERC），显示了导管对导管吻合口狭窄（图 2a）。作为第一次治疗，我们在支架内放置了一个带有近端皮瓣（8.5 Fr，9 厘米长）的塑料支架以桥接狭窄。3 个月后，我们尝试更换支架，然而，由于皮瓣固定牢固，支架移除很困难。为了使支架更换更容易，我们放置了一个缩短的皮瓣或近端