Bile Duct Cannulation Guided by a Percutaneous Transhepatic Biliary Drainage (PTBD) Tube: Modified Rendezvous Procedure.
- Author:
Hong Joo KIM
1
;
Seon Hyeong CHOI
;
Jung Ho PARK
;
Dong Il PARK
;
Yong Kyun CHO
;
Chong Il SOHN
;
Woo Kyu JEON
;
Byung Ik KIM
Author Information
1. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea. hongjoo3.kim@samsung.com
- Publication Type:Original Article
- Keywords:
Selective bile duct cannulation;
Percutaneous transhepatic biliary drainage;
Modified rendezvous technique
- MeSH:
Bile Ducts*;
Bile*;
Catheterization*;
Cholangiopancreatography, Endoscopic Retrograde;
Choledocholithiasis;
Diagnosis;
Drainage*;
Duodenum;
Endoscopy;
Gastroenterostomy;
Humans;
Hyperamylasemia;
Mortality
- From:Korean Journal of Gastrointestinal Endoscopy
2007;34(3):138-142
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: To describe a simple and useful modification of the rendezvous technique using a PTBD tube as guidance. METHODS: From January 2005 to August 2006, a total of 436 ERCPs were performed. A diagnosis of choledocholithiasis was made in 235 cases. Deep cannulation of the bile duct using standard techniques was unsuccessful in 27 patients (11.5%). A precut papillotomy led to successful cannulation in 16 out of these 27 patients (59.3%). The remaining 11 patients (40.7%) underwent PTBD with the tube tip placed in the second portion of the duodenum. Bile duct cannulation was attempted with the guidance of a PTBD tube in 9 cases. In the other 2 cases, the transduodenal approach was impossible due to a previous Billroth II operation. RESULTS: Bile duct cannulation guided by a PTBD tube, which is also known as a modified rendezvous procedure, was successful in 9 out of 11 patients (81.8%). Deep cannulation of the bile duct was achieved in 100% of patients, who could be treated by endoscopy. There were 7 cases of transient hyperamylasemia (77.8%) but no procedure-related major complications or mortality. CONCLUSIONS: Bile duct cannulation guided by a PTBD tube in patients with choledocholithiasis can be recommended when ERCP is unsuccessful using the standard technique.
