Open AccessA modification of rendezvous technique for endoscopically treating transected common bile duct following cholecystectomy
Author(s) -
Vishal Sharma,
K. V. Raghavendra Prasada,
Anirudh Arun,
Anupam Lal,
Rajesh Gupta,
Deepak Kumar Bhasin
Publication year - 2014
Publication title -
journal of digestive endoscopy
Language(s) - English
Resource type - Journals
eISSN - 0976-5050
pISSN - 0976-5042
DOI - 10.4103/0976-5042.147503
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , duodenum , catheter , cannula , bile duct , surgery , endoscopy , percutaneous , common bile duct , cholecystectomy , general surgery , pancreatitis
Endoscopic therapy is the standard of care for management of most benign biliary strictures. However, endoscopic therapy can fail in very tight strictures. We report a case of a 52-year-old lady who had complete bile duct transection with stricture after laparoscopic cholecystectomy. In initial attempt, at endoscopic retrograde cholangiopancreatography (ERCP), guidewire could not be negotiated endoscopically across the narrowing as there was complete cut off of the bile duct and so a percutaneous transhepatic biliary drainage (PTBD) was done and subsequently internalized into the duodenum. We cannulated the internalized end of PTBD catheter with the standard ERCP cannula with guidewire and advanced it across the biliary stricture. PTBD catheter was withdrawn externally, and the guidewire was left in the left ductal system. We report this innovation as this may be helpful in managing patients with ERCP after an initial PTBD has been successfully internalized into the duodenum