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The endoscopic ultrasonography-guided rendezvous technique for biliary cannulation: a technical review

  • Review article
  • Published:
Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Steady progress is being made in endoscopic biliary intervention, especially endoscopic ultrasonography (EUS)-guided procedures. The EUS-guided rendezvous technique (EUS-RV) is a salvage method for failed selective biliary cannulation. The overall success rate of EUS-RV in 247 cases from seven published articles was 74 % and the incidence of complications was 11 %. The main cause of failed rendezvous cannulation was difficulty passing a biliary stricture or papilla due to poor guidewire (GW) manipulation. A recent large study found a 98.3 % success rate and superiority to precutting. This report suggested using a hydrophilic guidewire. Major complications were bleeding (0.8 %), bile leakage (1.2 %), peritonitis (0.4 %), pneumoperitoneum (0.2 %), and pancreatitis (1.6 %). The approach routes for EUS-RV were transgastric, transduodenal short position, and transduodenal long position. The appropriate route for each patient should be used. GW selection for EUS-RV is critical, and a hydrophilic GW might be the most useful. The catheter can be inserted through the papilla alongside or over the wire. Alongside cannulation is convenient, but difficult. The problem with the over-the-wire technique is withdrawal of the GW in the accessory channel. EUS-RV is effective and safe, but is not established. The efficacy should be confirmed in a prospective comparative trial, and the necessary specialist equipment should be developed.

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Abbreviations

GW:

Guide-wire

EUS:

Endoscopic ultrasonography

EUS-RV:

Endoscopic ultrasonography-guided rendezvous technique

PTBD:

Percutaneous transhepatic biliary drainage

ERCP:

Endoscopic retrograde cholangiopancreatography

TG:

Trans-gastric

TD:

Trans-duodenal

TDS:

Trans-duodenal short position

TDL:

Trans-duodenal long position

EUS-CDS:

Endoscopic ultrasonography-guided choledochoduodenostomy

ALC:

Alongside cannulation

OWC:

Over-the-wire cannulation

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Conflict of interest

H. Isayama declares no financial disclosure.

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Hiroyuki Isayama, Yousuke Nakai, Natsuyo Yamamoto, Hirofumi Kogure & Kazuhiko Koike

  2. Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Kazumichi Kawakubo & Hiroshi Kawakami

  3. Department of Gastroenterology, Tokyo Medical University, Tokyo, Japan

    Takao Itoi

Authors
  1. Hiroyuki Isayama
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  2. Yousuke Nakai
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  3. Kazumichi Kawakubo
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  4. Hiroshi Kawakami
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  5. Takao Itoi
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  6. Natsuyo Yamamoto
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  7. Hirofumi Kogure
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  8. Kazuhiko Koike
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Corresponding author

Correspondence to Hiroyuki Isayama.

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Isayama, H., Nakai, Y., Kawakubo, K. et al. The endoscopic ultrasonography-guided rendezvous technique for biliary cannulation: a technical review. J Hepatobiliary Pancreat Sci 20, 413–420 (2013). https://doi.org/10.1007/s00534-012-0577-8

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  • DOI: https://doi.org/10.1007/s00534-012-0577-8

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