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To report a technique of peripheral biliary decompression by means of anastomosis of a bile duct in segment II of the liver to the lesser curvature of the stomach. Seven patients with unresectable biliary neoplasm were treated. After transhepatic catheterization of a segment II bile duct, the left lobe of the liver and the lesser curvature of the stomach were perforated under fluoroscopic and laparoscopic guidance. Anastomosis between the biliary tree and the stomach was maintained with a gastrostomy tube placed across the tract. After 2 weeks, the tube was removed and patency of the tract was preserved with a metallic stent. Three patients died, at 3, 6, and 9 months, respectively, without reocclusion; the other four were alive at 5 months without jaundice. One patient had an episode of cholangitis, which was resolved with antibiotic therapy. This …