Recently, our department successfully performed emergency endoscopic treatment on an elderly patient with acute septic cholangitis and infectious shock who was referred from a regional hospital, achieving a complete success and saving the patient’s life. The patient was a 68-year-old female who had undergone a kidney transplant in May 2004 for “diabetes mellitus and renal failure”; five days before the referral, she had been admitted to DiZhou Hospital for right upper abdominal pain, followed by fever and jaundice, with temperature fluctuating from 38.5C to 39.5C, and routine blood tests showing white blood cells The patient was diagnosed with “common bile duct stone and bile duct dilatation inside and outside the liver” by ultrasound and CT examination, and underwent conservative treatment such as anti-infection and cholestasis, but the patient’s condition did not improve. The patient’s condition progressively worsened and symptoms of infectious shock such as low blood pressure and shortness of breath appeared, and he was transferred to our department on the fifth day of illness. At the time of admission, the patient had epigastric pain, fever, jaundice, shortness of breath, low blood pressure, and low oxygen saturation, which was considered as “acute obstructive purulent cholangitis with infectious shock”. The patient’s abdominal pain disappeared, body temperature decreased, and jaundice gradually subsided. The condition improved significantly. Li Jun, Department of Gastroenterology, Second Affiliated Hospital of Kunming Medical University Acute obstructive suppurative cholangitis (AOSC) is a dangerous disease, prone to infectious shock and multi-organ failure. In the past, surgical drainage of the bile duct was mostly used to rescue the patient, and the death rate was as high as 20% to 40%. In recent years, with the improvement of endoscopic technology and the accumulation of experience of endoscopists, the success rate of endoscopy in the treatment of biliary tract diseases has been greatly improved, and the superiority has become more and more significant, saving the lives of many critically ill patients. Since AOSC is caused by blockage or stricture of the biliary tract, it is difficult for antibiotics to enter the biliary system due to poor bile excretion, so anti-infection and anti-shock treatment must be accompanied by early biliary drainage. The traditional surgical method uses a common bile duct incision and T-tube drainage, but due to the patient’s age and varying degrees of impaired liver function; often accompanied by more serious medical disease, the surgical risk is high; some patients also have a history of multiple biliary surgery, extensive intra-abdominal adhesions make the surgery easy to damage the surrounding organs, surgical complications and high mortality rate, the value of emergency endoscopic treatment of acute obstructive septic cholangitis is to use a very small The value of emergency endoscopic treatment of acute obstructive septic cholangitis is that it can solve bile duct obstruction with minimal trauma, which is undoubtedly an excellent treatment method and fully reflects the superiority of “minimally invasive treatment”. The efficacy of endoscopic treatment of acute septic cholangitis in the elderly is similar to that of surgery, but the safety of the latter is significantly higher. Our department is the first to carry out this technology in the province, and has successfully cured many cases of acute obstructive purulent cholangitis, which is recognized by patients and most medical staff. As the work progresses, we believe that many patients and medical personnel will understand and accept emergency endoscopic treatment of bile duct diseases and enjoy the safe and effective treatment effect of minimally invasive treatment technology.