Recently, our general interventional department performed biliary stenting and internal and external biliary drainage for a patient with complex high-grade obstructive jaundice. The patient had two stents placed on both sides of the left hepatic duct at the same time and three internal and external biliary drains were left in place, which is the first time such a difficult bile duct recanalization procedure is performed in our hospital and very rare in Guangxi. Mr. Su from Wuming, Guangxi, was admitted to the hospital with “skin yellowing for 1 month and skin itching for 1 week”, total bilirubin 301umol/, MRI examination suggesting a mass in the hilar region and obstructive expansion of intrahepatic bile ducts, which was considered to be caused by malignant tumor invasion. . The patient was transferred to our interventional department for further treatment. After detailed film review and discussion, the team of doctors leading the department suggested that the patient’s malignant tumor invaded the common hepatic duct and the upper part of the common bile duct, and that percutaneous hepatic percutaneous cholangiography could be performed from the right hepatic area under ultrasound guidance. Fortunately, the guidewire could reach the common bile duct from the left intrahepatic bile duct without any problems. Then two pairs of stents were placed from the left and right hepatic areas, and two internal and external biliary drains were placed respectively, so that the left and right hepatic bile ducts and the common bile duct were completely open. Intraoperative re-imaging showed that there was still a branch of the right hepatic duct with severe contrast retention, and this branch of the bile duct was obviously dilated, so an external bile duct was placed considering that this bile duct was not connected with other hepatic bile ducts. Almost all the intrahepatic bile ducts were opened and the operation was successfully completed. The patient’s skin was no longer itchy the day after the operation, and the total bilirubin dropped significantly after one week. In the past, our department has solved a large number of patients’ biliary obstruction through minimally invasive interventions, such as low obstruction caused by tumors or stones in the jugular abdomen, high obstruction caused by primary tumors in the hilar region or tumors metastasized from gastric cancer and intestinal cancer, and acute suppurative cholangitis caused by stones or tumors. Successful resolution of obstruction at various sites in these patients has provided us with a wealth of experience in clinical work. A large number of low obstructions can be solved relatively easily by interventional methods of single stent placement, external drainage or internal and external drainage. Patients with obstructions that are not easily passed by internal ERCP or patients with serious underlying diseases that are difficult to be solved by medical or surgical methods may consider minimally invasive interventional methods to solve them. There was a case that a patient was confirmed to have coronary artery disease by coronary angiography, and the severe 3-branch lesion required surgical coronary artery bypass surgery, but unfortunately the patient had a low-level biliary obstruction caused by bile duct stones before surgery, and the whole body skin and sclera were yellowish, so the bypass surgery could not be performed. The patient underwent coronary artery bypass surgery successfully, followed by ERCP in internal medicine to resolve the common bile duct stone. In contrast, high obstruction often requires multiple drains or multiple stent placements to resolve, and we have had some difficulty in resolving high obstruction through minimally invasive interventions of double stent placement or double drainage tube drainage in the past, but most of them have been successful. We have not encountered cases requiring 3 or more drains before, but the success of double stent placement and 3 drains not only relieved the patient of the pain caused by high obstruction, but also made a small step forward in our interventional technique.