Figure 1

Bilateral self-expandable metal stents (SEMS) placement using a stent-within-stent technique. (A) After deployment of the first stent across the hilar stricture, the guidewire was inserted, under fluoroscopic guidance, into the contralateral hepatic duct trough the interstices of the initial SEMS. (B) Dilatation of the interstices of the first SEMS with a hydrostatic balloon to facilitate the passage of a second SEMS into the contralateral hepatic duct. (C) Bilateral SEMS placement obtaining a Y-shaped configuration.