Side-by-side dual echoendoscope and ultrathin endoscopy to facilitate EUS-ERCP biliary rendezvous

Abstract

Endoscopic ultrasound (EUS)-guided biliary access is performed when standard endoscopic retrograde cholangiopancreatography (ERCP) techniques fail and for inaccessible papillae [1]. EUS rendezvous requires passage of the guide wire into the duodenum, with subsequent removal of the echoendoscope and insertion of a second endoscope to grasp the distal end of the wire. During echoendoscope withdrawal, the position of the guide wire is tenuous. We describe EUS rendezvous whereby passage of a small-caliber endoscope alongside the echoendoscope stabilizes the position of the guide wire.