We present an 83-year-old female with a history of metastatic gastric cancer and a surgical jejunostomy tube. She presented to our hospital 2 months earlier with complete gastric outlet obstruction and underwent a successful EUS-guided gastrojejunostomy, enabling resumption of oral intake. She returned on this admission with cholangitis secondary to a distal CBD obstruction (Bili: 3.7). An intrahepatic duct (3.5 mm) at segment 3 was punctured with a 19-gauge needle. A wire was navigated to the CBD, crossed the biliary stricture, and reached the duodenum. The tract was dilated with a 4 mm balloon. Two overlapping Gore stents were deployed at the hepaticogastrostomy. Her symptoms resolved, and her bilirubin normalized three days later.