Repeated rendezvous treatment of PTBD and ERCP in patients with recurrent obstructive jaundice

Repeated applications of rendezvous technique combining percutaneous transhepatic biliary drainage (PTBD) with endoscopic retrograde cholangiopancreatography (ERCP) (PE) in patients with recurrent obstructive jaundice have not been reported. The present study aimed to evaluate treatment effects of this technique in patients who previously received the same rendezvous treatment.

Repeated PE rendezvous procedure was performed in 27 patients who received the same procedure previously and had recurrent obstructive jaundice. Twenty-two patients were treated by second-time rendezvous procedure and five patients by third-time. The clinical characteristics and therapeutic effects were retrospectively analyzed.

By means of repeated rendezvous technique, 26 patients gained access to the bile duct and were successfully implanted new stents, only one failed with stent implantation. Total serum bilirubin level decreased within one week from 221.89 +/- 64.70 micromol/L to 156.0 +/- 32.2 micromol/L in patients with second-time treatment and from 297.07 +/- 109.12 micromol/L to 238.77 +/- 36.81 micromol/L in patients with third-time treatment. There was no severe complications observed that are associated with repeated PE procedure.

Rendezvous procedure of PTBD and ERCP could be used repeatedly and effectively for patients who present recurrent obstructive jaundice after ERCP failure.