We report on a 63-year-old female patient with locally advanced cholangiocarcinoma of the extrahepatic biliary tract. She was admitted with progressive obstructive jaundice, initiating cholangitis and distinctive itching. The biliodigestive anastomosis was secondarily barred by tumour infiltration and not accessible via an endoscopic route. Because the patient asked expressively for internal drainage, we successfully performed an endosonography-guided transgastric, transhepatic internal biliary drainage (EUCD). The jaundice and itching were regredient and the patient was discharged in a stable condition.
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