Endoscopic retrograde cholangio pancreatography (ERCP) is the procedure of choice for biliary decompression in individuals with obstructive jaundice. In those cases when ERCP fails, the alternatives are to refer the case to a highly specialized center and repeat the procedure, or decompress the bile ducts either percutaneously or surgically. The proximity of the endoscopic ultrasound (EUS) probe from the stomach and duodenum to the hepatobiliar system and pancreas allows ultrasound-guided access into the bile and pancreatic duct. We present what to our knowledge is the first description in Mexico of a therapeutic interventional EUS guided cholangiography in a patient with cholecystitis and choledocolithiasis in whom initial ERCP failed to decompress de bile duct.
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