Recently, the Department of Gastroenterology of our hospital, in cooperation with Zhongshan Cancer Hospital, completed the first ultrasound endoscopy-guided transgastric intrahepatic bile duct puncture for stent placement of common bile duct stenosis in Hunan Province. The patient, Zhu, had advanced follicular lymphoma with extensive involvement of the mediastinum and abdominal cavity, and the abdominal cavity was filled with a huge tumor (part of the fusion exceeded 10 cm). Due to the compression of the huge intra-abdominal mass, the patient recently developed obstructive jaundice, and MRCP indicated a bird’s beak-like external compressional stenosis of the upper part of the common bile duct, significant dilatation of the intrahepatic bile duct, and bilirubin as high as 485.6 μmol/L (22 times higher than the normal value), which further aggravated the liver function damage by siltation and made the patient’s follow-up treatment extremely difficult, so bile drainage became an urgent problem. The patient tried to undergo endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic bile duct puncture, all of which were unsuccessful or impossible due to narrow tumor infiltration in the duodenal bulb and unsatisfactory puncture route. Prof. Wang Fen and Prof. Wang Xiaoyan, director of the Department of Gastroenterology, carefully analyzed the condition and concluded that ultrasound endoscopy-guided transgastric intrahepatic bile duct puncture with stent placement for common bile duct stenosis could be performed for the patient. After repeated preoperative studies and arguments and a lot of preparations, the patient underwent left intrahepatic bile duct puncture at the base of the stomach in the afternoon of June 24 with the strong support of the department head, Prof. Xiaoyan Wang, and with the full cooperation of the orthopedic department, operating room and anesthesia department. After several attempts by Prof. Wang Fen, the guidewire was passed through the left hepatic duct, the confluence of the left and right hepatic ducts, and the stenotic segment of the common bile duct in a smooth way into the common bile duct and then out through the duodenal papilla, and finally a bare stent was placed into the stenotic segment of the common bile duct along the guidewire through the stomach wall. The operation was a great success, and the bile that had been troubling the patient for days after the stent was placed instantly flowed out through the duodenal papilla. After the operation, the patient’s general condition was good and there were no complications related to the operation. 5 days later, the patient’s transaminases had returned to normal and the bilirubin had dropped from over 400 to 100 μmol/L. He has now been transferred to the oncology department for follow-up treatment. Since 2013, the Department of Gastroenterology of our hospital has carried out a number of advanced ultrasound endoscopic techniques such as endoscopic ultrasound-guided fine needle aspiration cytology, ultrasound endoscopic-guided abdominal trunk plexus block, and ultrasound endoscopic-guided intragastric stent drainage for pancreatic pseudocysts. On the basis of these techniques, the first ultrasound endoscopy-guided intrahepatic bile duct puncture and paralleling common bile duct stent placement in Hunan Province was completed. The mature application of these ultrasound endoscopic techniques will bring gospel to the diagnosis and treatment of patients with lesions in the thoracic and abdominal cavities outside the gastrointestinal tract, especially in the areas of pain relief for advanced tumors and relief of obstructive jaundice, etc. It also marks the leading position of ultrasound endoscopic treatment technology in the province of gastroenterology.