The case is a 79-year-old man. Emergency ERCP was performed due to severe acute cholangitis, and stone extraction was performed after EST. On the 6th postoperative day, tarry stool was observed. Emergency upper endoscopy showed a large amount of blood clot adhered to the Vater's ampulla. It was difficult to secure a visual field, and a fully covered metallic stent was placed to perform compression hemostasis. The procedure completed without any complications. Ten days later, the stent was removed by the snare and the patient was discharged with good progress. Compression with a metallic stent is effective for severe post-EST bleeding.
