A 74-year-old female was admitted to our hospital because of obstructive jaundice. Biliary metallic expandable stent (MES) was inserted for treatment of biliary obstruction because of pancreas head cancer before 11 months. Percutaneous transhepatic biliary drainage was performed and the puncture tract was dilated to 20 Fr which was necessary for percutaneous transhepatic cholangiography. And than, percutaneous cholangioscopy (2.3mm flexible endoscope) was performed. We used the guidewire to keep the lumen. Permanent irrigation with saline was applied via the scope's working channel. At the first, cholangingraphic findings were bile debris and sludge filled in MES. Bile debris adherent to MES was removed using endoscopy as possible. At the last, cholangiography showed the sooth inner surface of MES and free metallic surface without granulation. In summary, this case was that percutaneous transhepatic cholangiography for stent occlusion was useful and the inner surface of the stent after removed bile debris was regular and smooth without granulation.
