Multi-holed fully covered self-expandable metal stent to dilate a benign hepaticojejunostomy anastomotic stricture

In balloon-assisted enteroscopy (BAE)-guided recanalization in patients with benign hepaticojejunostomy anastomotic strictures (HJAS), balloon dilation followed by plastic stent placement maintains long-term recanalization [1]. Temporary placement of a fully covered self-expandable metal stent (FCSEMS) may increase stricture patency rates. However, an FCSEMS may cause acute cholangitis by blocking the biliary bifurcations. Therefore, additional plastic stents are sometimes required to preserve bifurcations [2] [3]. A recently developed removable multi-holed FCSMES (MH-FCSEMS) is designed to preserve the biliary branches even when placed unilaterally in the perihilar stricture [4] [5]. Herein, we report a patient in whom the HJAS was successfully recanalized without cholangitis using the MH-FCSEMS under BAE guidance.