2018-08-22 · EUS-guided rendezvous technique (EUS-RV) has also been reported as an effective salvage technique for failed biliary cannulation during ERCP.[1–6] In EUS-RV, the biliary duct is punctured from the intestine under EUS guidance using a needle for fine needle aspiration (FNA), followed by guidewire placement into the duodenum through the needle, biliary duct and ampulla.

Conclusions: EUS is a feasible technique for allowing rendezvous drainage of obstructed biliary or pancreatic ducts through native papillae or anastomoses after initially unsuccessful ERCP. AB - Background: Only a few cases have been reported of EUS-guided drainage of obstructed pancreatic or bile ducts.

Design: Retrospective study. 2018-08-22 Endoscopic ultrasonography (EUS)‐guided pancreatic duct (PD) stenting for patients with failed conventional endoscopic retrograde cholangiopancreatography (ERCP) and EUS‐guided rendezvous technique. (A) Fluoroscopic image demonstrates a transgastric pancreatogram. The technical complexity of rendezvous, EDGE and gastroenterostomy is high and requires extensive experience in therapeutic EUS and ERCP. A multidisciplinary management of the complications is often required, so in our opinion these techniques should be performed exclusively in tertiary hospitals with interventional radiologists and biliopancreatic surgeons available. EUS-guided duct access and intraductal guidewire placement was accomplished in 5 of 6 cases, with successful traversal of the obstruction, and rendezvous ERCP, with stent placement in 3 of 6 cases The rendezvous procedure, being a hybrid EUS‐ERCP procedure, with the role of EUS being limited to providing access, was classified separately from EUS‐BD. The latter was further classified into transluminal and antegrade procedures, depending upon whether the drainage was done above the obstruction or through the obstruction.

Main outcome measurements were rates of procedural success and complications. RESULTS: EUS-guided biliary rendezvous was successful in 14 patients (93.3%). Failure was seen in one patient due to a tight malignant biliary stricture. För att EUS och MRCP skall vara kostnadseffektivare för denna patientgrupp krävs att sannolikheten för att behöva terapeutisk ERCP måste vara lägre än 25 %.

EUS-guided duct access and intraductal guidewire placement was accomplished in 5 of 6 cases, with successful traversal of the obstruction, and rendezvous ERCP, with stent placement in 3 of 6 cases

Hence, EUS-guided rendezvous (EUS-RV) was considered. When ERCP fails to achieve selective cannulation, endoscopic ultrasound (EUS)-guided rendezvous procedure may be useful to access the PD for endotherapy. Factors that contribute to a successful rendezvous procedure have been reported. 7,9 Among the various factors, a dilated PD seems to be essential for a successful EUS rendezvous procedure.

Similar to ERCP, EUS techniques are used to manage benign and malignant diseases. The use of EUS-guided biliary drainage (EUS-BD) can be used after failed ERCP for management of unresectable malignancy, but caution against its use for resectable disease, as these interventions may risk tumor seeding. For benign

Failure was seen in one patient due to a tight malignant biliary stricture.

ERC-PTC rendezvous techniques are used as a salvage technique after failed ERC or anticipating a complex intervention that might not be resolved by ERC alone. A main advantage of PTC over ERCP is the Video1 Endoscopic ultrasound-guided rendezvous endoscopic retrograde cholangio-pancreatography using a steerable access device. Marrache Mohamad K et al. EUS-guided rendezvous ERCP with steerable access device… Endoscopy 2020; 52: E355–E356 E355 This document was downloaded for personal use only. Unauthorized distribution is strictly EUS-rendezvous provided safe and reliable transpapillary bile duct access after failed ERCP cannulation. The selection of the appropriate approach routes, depending on patient condition, is critical.
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Therefore, EUS allows ERCP to be performed. The simplest technique included in this stage is EUS-guided rendezvous. 2017-06-21 ary drainage was reported for the first time (10). EUS-guided rendezvous (EUS-RV) techniques were first reported in 2004 by Mallery (11). Recently, EUS-RV has been re-ported as an effective salvage technique after failed ERCP.

Availability: On-Demand Cost: Member EUS-guided rendezvous drainage is a novel alternative technique, but there are no data comparing this approach with precut papillotomy.
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EUS rendezvous or direct intervention involves: (1) using endoscopic-ultrasound technology to access the bile duct with a small needle and manipulate a wire across the biliary orifice and into the duodenum to be then retrieved endoscopically for ERCP (rendezvous ERCP), or (2) using endoscopic-ultrasound technology to directly puncture and perform intended biliary therapy

EUS-guided rendezvous ERCP with steerable access device… Endoscopy 2020; 52: E355–E356 E355 This document was downloaded for personal use only. Unauthorized distribution is strictly Endoscopic ultrasound (EUS)-assisted biliary access is utilized when conventional endoscopic retrograde cholangiopancreatography (ERCP) fails.

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May 16, 2019 ERCP-guided biliary drainage is performed by direct cannulation of the papilla EUS-guided rendezvous (EUS-RV) transpapillary drainage is

We report a 10-year experience utilizing a transduodenal EUS rendezvous via a transpapillary route without dilation of the transduodenal tract, followed by immediate ERCP access. Endoscopic retrograde cholangiopancreatography (ERCP) requires deep biliary cannulation. When deep biliary cannulation is failed, the endoscopic ultrasonography rendezvous technique (EUS-RV) is a 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. abled various endoscopic ultrasound-related diagnostic and therapeutic techniques to be performed, such as fine-needle aspiration (FNA) (7), pancreatic pseudocyst drainage (8), and celiac plexus neurolysis (9).