(A) Endoscopic retrograde cholangiography shows the severe stricture and distal localized saccular dilatation of the hilar bile duct (arrow). (B) Contrast-enhanced computed tomography 11 years after proton beam therapy (PBT) reveals blood flow in the saccular dilatation (white arrow) of the hilar bile duct adjacent to the left portal vein (black arrow) and remarkable right hepatic lobe shrinkage due to PBT.