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Endoscopic re-intervention following placement of multiple self-expandable metal stents (SEMSs) is challenging [1– 3]. A suitable re-intervention for malignant hilar biliary obstruction (MHBO) is not available. Plastic stents are used for re-intervention following placement of multiple SEMSs, but advancing the plastic stents through the mesh of the SEMS is difficult. This report describes successful side-by-side (SBS) metal stent deployment for recurrent MHBO after placement of SEMSs. A 69-year-old man underwent endoscopic multistent drainage (8mm×8cm and 8mm×6cm; BileRush Selective; Piolax, Kanagawa, Japan) using a partial stent-in-stent (SIS) technique for MHBO due to a recurrent lesion after left lob-

Novel side-by-side metal stent placement for recurrent hepatic hilar obstruction after placement of multiple metal stents