Postoperative pancreaticojejunal leaks after Whipple procedure are challenging, especially when complicated by external fistulas. A 73-year-old man developed a postoperative intra-abdominal collection with a cutaneous fistula after pancreaticoduodenectomy including antrectomy, gastrojejunostomy, and hepaticojejunostomy. EUS-guided internal drainage was performed to reverse the fistulous flow. Under linear EUS guidance, the collection near the pancreaticojejunal anastomosis was punctured through the remaining stomach, despite limited access related to antrectomy. A 10 Fr cystotome was used to create a tract, and two 7 Fr double-pigtail plastic stents were placed for internal drainage. The external output stopped within days, with full recovery maintained at follow-up. This case highlights EUS-guided internal drainage as an effective minimally invasive alternative to surgery.