“…Recently, EUS-TA using an oblique-viewing echoendoscope inserted over a guidewire into the afferent limb has been reported 2 , but there is the risk of perforation. Although forward-viewing echoendoscopes can be safely inserted into the distal intestinal tract, there are few reports about EUS-TA via the afferent limb using them 3 4 . Here, we describe a patient with surgically altered anatomy who underwent EUS-TA using a forward-viewing echoendoscope for recurrent cancer of the distal bile duct.…”