Different options of endosonography-guided biliary drainage after endoscopic retrograde cholangio-pancreatography failure

Figure 2 Patient with acute pancreatitis after cholecystectomy and Billroth II gastrectomy. Endosonography (EUS)-guided rendez-vous technique. A: EUS image with dilation of the intrahepatic biliary duct; B: EUS-guided cholangiography; C: Insertion of the guidewire across the duodenal papilla and positioning in the duodenum; D: Capture of the guidewire with a frontal view endoscope; E: Balloon dilatation of the duodenal papilla; F: Insertion of a 10 Fr plastic stent.