When Endoscopic retrograde cholangiopancreatography (ERCP) fails in patients with obstructive jaundice, EUS-guided rendezvous technique (EUS-RV) becomes an alternative treatment. For the EUS-RV, we can puncture the intrahepatic bile duct (IHBD) and the extrahepatic bile duct (EHBD). Puncturing the EHBD needs through duodenum, the puncture site can be divided into via the proximal duodenum (D1) and via the second portion of the duodenum (D2). Puncturing the IHBD will difficult to perform at the patients whose IHBD is not dilated. For these patients, puncturing EHBD becomes an unavoidable choice. Generally, the closer the puncture point is to the duodenal papilla, the more difficult it is to implant the stent. Therefore, we innovatively adopted the method that concomitantly withdrawing the guidewire during stent deployment.
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A 73-year-old woman presented with a pancreas divisum was admitted for acute pancreatitis. Abdominal CT was performed due to a torpid evolution with fever and oral intolerance, demonstrating necrosis and ductal disruption in the pancreatic neck. An ERCP was attempted, however, the minor papilla (MP) could not be identified because of the presence of edematous duodenal folds.
View Article and Find Full Text PDFThe EUS-guided rendezvous technique was performed for stent implantation.
Rev Esp Enferm Dig
March 2025
Biliopancreatic Endoscopic Surgery, The Second Hospital of Hebei Medical University, china.
When Endoscopic retrograde cholangiopancreatography (ERCP) fails in patients with obstructive jaundice, EUS-guided rendezvous technique (EUS-RV) becomes an alternative treatment. For the EUS-RV, we can puncture the intrahepatic bile duct (IHBD) and the extrahepatic bile duct (EHBD). Puncturing the EHBD needs through duodenum, the puncture site can be divided into via the proximal duodenum (D1) and via the second portion of the duodenum (D2).
View Article and Find Full Text PDFEUS-guided rendezvous is a viable salvage technique for failed billiary cannulation in patients with Roux-en-Y gastric bypass undergoing BAE-ERCP.
Endosc Int Open
February 2025
Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, United States.
Background And Study Aims: Biliary cannulation via balloon-assisted-ERCP (BAE-ERCP) can be challenging. Patients with Roux-en-Y gastric bypass (RYGB) have among the lowest reported BAE-ERCP success rates when compared with other types of surgically altered anatomy. We explored the role of EUS-guided rendezvous (EUS-RV) as a rescue technique when BAE-ERCP fails.
View Article and Find Full Text PDFLost ampullary opening post endoscopic submucosal dissection: EUS-guided rendezvous shows the path.
VideoGIE
January 2025
Department of Endoscopy, NTT Medical Center Tokyo, Tokyo, Japan.
Rescue cannulation techniques in difficult biliary access-A comprehensive review.
Indian J Gastroenterol
February 2025
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
Selective biliary cannulation is the prerequisite for successful biliary interventions. In the setting of cannulation failure, various rescue cannulation techniques are used for achieving selective biliary access. The various rescue cannulation techniques are (1) free-hand techniques (precut papillotomy and fistulotomy); (2) wire-guided techniques (transpancreatic sphincterotomy [TPS] and double guidewire [DGW]) and (3) endoscopic ultrasound (EUS)-guided technique (EUS-guided rendezvous for biliary access).
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