Case Report
Copyright ©2010 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 14, 2010; 16(42): 5388-5390
Published online Nov 14, 2010. doi: 10.3748/wjg.v16.i42.5388
Modified rendezvous intrahepatic bile duct cannulation technique to pass a PTBD catheter in ERCP
Tae Hoon Lee, Sang-Heum Park, Sae Hwan Lee, Chang-Kyun Lee, Suck-Ho Lee, Il-Kwun Chung, Hong Soo Kim, Sun-Joo Kim
Tae Hoon Lee, Sang-Heum Park, Sae Hwan Lee, Chang-Kyun Lee, Suck-Ho Lee, Il-Kwun Chung, Hong Soo Kim, Sun-Joo Kim, Division of Gastroenterology, Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Cheonan Hospital, 23-20 Bongmyung-dong, Cheonan-si, Chungcheongnam-do, 330-721, South Korea
Author contributions: Lee TH, Kim HS and Kim SJ designed the case report; Lee SH, Lee CK, Lee SH and Chung IK provided clinical advice; Lee TH performed the procedure; Lee TH wrote the paper; Park SH revised the paper.
Correspondence to: Tae Hoon Lee, MD, Division of Gastroenterology, Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Cheonan Hospital, 23-20 Bongmyung-dong, Cheonan-si, Chungcheongnam-do, 330-721, South Korea. thlee9@lycos.co.kr
Telephone: +82-41-5703662 Fax: +82-41-5745762
Received: July 14, 2010
Revised: August 25, 2010
Accepted: September 2, 2010
Published online: November 14, 2010
Abstract

The rendezvous procedure combines an endoscopic technique with percutaneous transhepatic biliary drainage (PTBD). When a selective common bile duct cannulation fails, PTBD allows successful drainage and retrograde access for subsequent rendezvous techniques. Traditionally, rendezvous procedures such as the PTBD-assisted over-the-wire cannulation method, or the parallel cannulation technique, may be available when a bile duct cannot be selectively cannulated. When selective intrahepatic bile duct (IHD) cannulation fails, this modified rendezvous technique may be a feasible alternative. We report the case of a modified rendezvous technique, in which the guidewire was retrogradely passed into the IHD through the C2 catheter after end-to-end contact between the tips of the sphincterotome and the C2 catheter at the ampulla’s orifice, in a 39-year-old man who had been diagnosed with gallbladder carcinoma with a metastatic right IHD obstruction. Clinically this procedure may be a feasible and timesaving technique.

Keywords: Endoscopic retrograde cholangiopancreatography; Intrahepatic bile duct; Rendezvous technique