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Case Reports
. 2017 May;12(1):46-49.
doi: 10.2185/jrm.2918. Epub 2017 May 24.

The rendezvous technique involving insertion of a guidewire in a percutaneous transhepatic gallbladder drainage tube for biliary access in a case of difficult biliary cannulation

Fumiko Sunada  1 , Naoki Morimoto  2 , Mamiko Tsukui  1   2 , Hidekazu Kurata  1
Affiliations
Case Reports

The rendezvous technique involving insertion of a guidewire in a percutaneous transhepatic gallbladder drainage tube for biliary access in a case of difficult biliary cannulation

Fumiko Sunada et al. J Rural Med. 2017 May.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic method and treatment approach for biliary diseases. However, biliary cannulation can be difficult in some cases. We performed ERCP in a 97-year-old woman with abdominal pain resulting from acute cholangitis caused by choledocholithiasis and observed difficult biliary cannulation. Eventually, the patient was successfully treated with the rendezvous technique. We could not cannulate the biliary duct during ERCP twice. Therefore, we placed a percutaneous transhepatic gallbladder drainage (PTGBD) tube without intrahepatic dilation. The rendezvous technique was performed using the PTGBD tube. The patient did not experience pancreatitis or perforation.

Keywords: difficult biliary cannulation; endoscopic retrograde cholangiopancreatography; percutaneous transhepatic gallbladder drainage; rendezvous technique.

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Figures

Figure 1
Figure 1
Abdominal computed tomography scan showing choledocholithiasis (8 mm in diameter).
Figure 2
Figure 2
The PTGBD tube placed near the cystic duct as much as possible.
Figure 3
Figure 3
The rendezvous technique involving a percutaneous transhepatic gallbladder drainage tube.
Figure 4
Figure 4
Guidewire placement and duodenal endoscopy.
See this image and copyright information in PMC

References

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