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Using the Rendezvous Technique Through Choledochoduodenostomy for Malignant Biliary Obstruction
Alexandra Fiedler1, Banreet Dhindsa2, Ishfaq Bhat3
1Division of Internal Medicine, University of Nebraska Medical Center, Omaha, NE.
ACG Case Reports Journal
|June 6, 2024
Summary
A novel rendezvous procedure using a pre-existing choledochoduodenostomy effectively relieved biliary obstruction after failed endoscopic retrograde cholangiopancreatography. This approach offers a new option for complex biliary drainage cases.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Biliary Interventions
Background:
- Endoscopic transpapillary biliary stenting via ERCP is standard for distal biliary obstruction.
- Endoscopic ultrasound-guided choledochoduodenostomy is an alternative for ERCP failure, with a good safety profile.
- Stent occlusion complicates choledochoduodenostomy in 9%-26% of cases.
Observation:
- This case report details a patient with biliary obstruction.
- Previous endoscopic retrograde cholangiopancreatography (ERCP) had failed.
- The patient had a pre-existing choledochoduodenostomy.
Findings:
- A rendezvous procedure was performed utilizing the existing choledochoduodenostomy.
- This novel approach successfully relieved the biliary obstruction.
- This represents the first reported instance of this specific technique.
Implications:
- This technique may offer a viable alternative for managing complex biliary obstruction.
- It highlights the versatility of endoscopic ultrasound-guided procedures.
- Further research is warranted to evaluate the long-term efficacy and safety of this approach.
