Obstructive Jaundice With Cholangitis

55 Year old female right renal cell carcinoma with duodenal stenosis with Enteral SEMS insitu with obstructive Jaundice with cholangitis. IHBR was not much dilated. Biliary drainage require for optimization of serum bilirubin level before surgery and relive cholangitis. Only thing remains for biliary Drainage is distended GB. Hence EUS guided cholecystgastrostomy done.