Fig. 1

Holmium laser ablation for biliary stricture in a representative case, who had biliary stricture at the left hepatic duct. a A cartoon demonstration of biliary stricture ablation by laser ablation via T tube access. The arrows indicate the spiral cutting route in laser ablation. b Preoperative magnetic resonance cholangiopancreatography (MRCP) did not show the visualization of the distal biliary duct in the left lobe. c Postoperative T-tube cholangiography study showed visualization of the distal biliary duct. d The biliary stricture visualized during cholangioscopy. The yellow triangle indicates the stricture. e Initiation of holmium laser ablation at the stricture. f Holmium laser ablation in a spiral cutting manner. g Laser ablation accomplished, with relieved stricture allowing for cholangioscopy to pass through. h Multiple pigment stones observed in the distal biliary duct beyond the stricture location