A 69-year-old man, six years post–orthotopic liver transplantation for alcoholic cirrhosis, presented with abnormal liver-function tests. 3D-MRCP showed a 14-mm dilation of the common hepatic duct and marked caliber mismatch at the biliary anastomosis. ERCP failed to achieve guidewire passage despite standard techniques and cholangioscopy revealed minimal bile flow without a visible orifice. Bite-on-bite attempts were unsuccessful. A 0.3-mm polypectomy snare was modified by removing its protective sheath to create a cutting tool compatible with the cholangioscope. During a second ERCP, a small endocut incision enabled proximal duct cannulation, balloon dilation (6 mm), and placement of a fully covered metal stent. Four-month follow-up ERCP showed normal intrahepatic ducts and a significantly improved anastomotic caliber.