Endoscopic-percutaneous rendezvous procedure for the management of difficult biliary tract: experience in an endoscopic center in Lima-Peru

• Autores: Sánchez Cerna, Víctor, Araujo Almeyda, Gustavo, Aliaga Ramos, Josue, Reyes Mugruza, Tania, Celedonio-Campos, Williams, Alcántara Figueroa, Christian
• Formato: artículo
• Fecha de Publicación: 2024
• Institución: Sociedad de Gastroenterología del Perú
• Repositorio: Revista de Gastroenterología del Perú
• Lenguaje: español
• OAI Identifier: oai:ojs.revistagastroperu.com:article/1703
• Enlace del recurso: https://revistagastroperu.com/index.php/rgp/article/view/1703
• Nivel de acceso: acceso abierto
• Materia: Colangiopancreatografia retrógrada endoscópica; Vía biliar; Coledocolitiasis; Cholangiopancreatography, endoscopic retrograde; Biliary tract; Choledocholithiasis

Objectives: Biliary access refractory to conventional cannulation techniques is a challenging clinical scenario for most endoscopists. The endoscopic-percutaneous rendezvous technique is an optimal alternative with high success rates and low complication rates in expert hands, however its routine use in the West, mainly in Latin America, is still limited. The aim of our study was to evaluate the feasibility, efficacy and safety of endoscopic-percutaneousrendezvous in the management of difficult biliary tract in an endoscopic center in Peru. Materials and methods: Descriptive study - case series type that included 21 patients, with diagnosis of difficult bile duct, all treated by endoscopic-percutaneous rendezvous between July 2017 to July 2020. We evaluated: age, gender, number of previous failed endoscopic retrograde cholangiopancreatography, associated endoscopic findings, rate of successful cannulation, rate of successful resolution of  difficult choledocholithiasis, adverse events andprocedure-related mortality. Results: The rate of successful cannulation was 100% (21/21). There were 12 cases (57.1%) of difficult choledocholithiasis of which there was a successful resolution rate of 91.6% (11/12). The overall  adverse event rate was 4.7% (1/21), which was one case of post-sphincteroplasty gastrointestinal bleeding that was successfully resolved endoscopically only. Conclusions: Endoscopic-percutaneous rendezvous performed by expert hands is feasible, safe and clinically effective for the management of the difficult bile duct in Latin America.