Endoscopic Biliary Reconstruction Post Pancreaticoduodenectomy

A 29 year old female who previously underwent a pylorus preserving pancreaticoduodenectomy for an insulinoma 9 months previously presented with a biliary stricture causing obstructive jaundice. Attempts to traverse the stricture radiologically were unsuccessful. The stricture could not be reached with a paediatric colonoscope and she was considered for surgical revision of the hepaticojejunostomy. Prior to this, one final attempt at endoscopic revision of the hepaticojejunostomy was made.