Endoscopic Ultrasound-Guided Rendezvous Technique for Failed Biliary Cannulation in Benign and Resectable Malignant Biliary Disorders

Hideyuki Shiomi, Kentaro Yamao, Noriyuki Hoki, Takeshi Hisa, Takeshi Ogura, Kosuke Minaga, Atsuhiro Masuda, Kazuya Matsumoto, Hironari Kato, Hideki Kamada, Daisuke Goto, Hajime Imai, Mamoru Takenaka, Chishio Noguchi, Hidefumi Nishikiori, Yasutaka Chiba, Hiromu Kutsumi, Masayuki Kitano

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Endoscopic ultrasound-guided rendezvous technique (EUS-RV) has emerged as an effective salvage method for unsuccessful biliary cannulation. However, its application for benign and resectable malignant biliary disorders has not been fully evaluated. Aims: To assess the efficacy and safety of EUS-RV for benign and resectable malignant biliary disorders. Methods: This was a multicenter prospective study from 12 Japanese referral centers. Patients who underwent EUS-RV after failed biliary cannulation for biliary disorder were candidates for this study. Inclusion criteria were unsuccessful biliary cannulation for therapeutic endoscopic retrograde cholangiopancreatography with benign and potentially resectable malignant biliary obstruction. Exclusion criteria included unresectable malignant biliary obstruction, inaccessible papillae due to surgically altered upper gastrointestinal anatomy or duodenal stricture, and previous sphincterotomy and/or biliary stent placement. The primary outcome was the technical success rate of biliary cannulation; procedure time, adverse events, and clinical outcomes were secondary outcomes. Results: Twenty patients were prospectively enrolled. The overall technical success rate and median procedure time were 85% and 33 min, respectively. Guidewire manipulation using a 4-Fr tapered tip catheter contributed to the success in advancing the guidewire into the duodenum. Adverse events were identified in 15% patients, including 2 with biliary peritonitis and 1 mild pancreatitis. EUS-RV did not affect surgical maneuvers or complications associated with surgery, or postoperative course. Conclusions: EUS-RV may be a safe and feasible salvage method for unsuccessful biliary cannulation for benign or resectable malignant biliary disorders. Use of a 4-Fr tapered tip catheter may improve the overall EUS-RV success rate.

Original languageEnglish
Pages (from-to)787-796
Number of pages10
JournalDigestive Diseases and Sciences
Volume63
Issue number3
DOIs
Publication statusPublished - Mar 1 2018

Keywords

  • Benign and resectable malignant biliary disorders
  • Endoscopic ultrasonography
  • Endoscopic ultrasound-guided fine needle aspiration
  • Endoscopic ultrasound-guided rendezvous technique
  • Unsuccessful biliary cannulation

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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    Shiomi, H., Yamao, K., Hoki, N., Hisa, T., Ogura, T., Minaga, K., Masuda, A., Matsumoto, K., Kato, H., Kamada, H., Goto, D., Imai, H., Takenaka, M., Noguchi, C., Nishikiori, H., Chiba, Y., Kutsumi, H., & Kitano, M. (2018). Endoscopic Ultrasound-Guided Rendezvous Technique for Failed Biliary Cannulation in Benign and Resectable Malignant Biliary Disorders. Digestive Diseases and Sciences, 63(3), 787-796. https://doi.org/10.1007/s10620-018-4908-8