Abstract
Video 1EUS-guided hepaticogastrostomy using a rendezvous technique to enable cholangioscopy and electrohydraulic lithotripsy of left intrahepatic duct stones.
Highlights
The rendezvous technique to facilitate difficult biliary cannulation has been described.[1]
The peripheral duct at segment III was punctured with a 19-gauge needle (Fig. 3)
EUS showed large stones located in the dilated peripheral ducts of segment III (Fig. 2)
Summary
The rendezvous technique to facilitate difficult biliary cannulation has been described.[1] A temporary EUSguided hepaticogastrostomy followed by staged antegrade cholangioscopy and electrohydraulic lithotripsy has been described for the management of recurrent pyogenic cholangitis in patients with altered foregut anatomy.[2] penetrating the gastric wall to create the hepaticogastrostomy tract can prove challenging without the assistance of electrosurgical current.[3]. We describe the use of a salvage rendezvous technique to facilitate hepaticogastrostomy tract creation for the treatment of recurrent pyogenic cholangitis in a patient with native foregut anatomy when the conventional technique was initially unsuccessful. Unable to reach the target peripheral ducts because of a sharp angulation and resistance encountered. The peripheral duct at segment III was punctured with a 19-gauge needle (Fig. 3). Many attempts to dilate the hepaticogastrostomy tract using a balloon catheter and ERCP catheter failed because of the inability of these
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