A man in his 60s presented with epigastralgia and fever. Single-balloon endoscopy revealed pinhole-like stenosis at the bile duct jejunal anastomosis. After balloon dilation and placement of a plastic stent at the site, his symptoms improved. Stenosis at the anastomotic site within 1 year after bile duct jejunal anastomosis is a risk factor for restenosis after dilation, and he had undergone double-balloon endoscopic dilation 12 months after the anastomosis 11 years earlier. Because of the difficulty of the endoscopic approach, a single stent was placed for 1 year, whereas multiple stents should have been placed and replaced periodically. Despite the limited treatment of this high-risk case, the anastomotic site remained open for 10 years. These results suggest that long-term placement of a stent may be an option for patients who are difficult to approach endoscopically.
