Top tips for EUS-guided biliary rendezvous (with video)

      EUS-guided biliary drainage techniques come in several varieties, but EUS rendezvous may be the most commonly performed. In this technique, a guidewire is passed through a needle that has been used to puncture the biliary tree, either through the stomach or the duodenum. The wire is advanced to the duodenum through the ampulla, and cannulation can then be performed over, or next to, the wire, allowing transampullary access to the bile duct for sphincterotomy, stent placement, or other maneuvers. The procedure sounds simple, but in reality it can be challenging even for an experienced advanced endoscopist. Even in 2022, these techniques are relatively rarely performed at most centers. In this Top Tips, Dr Vinay Dhir walks us through some of the most important lessons he has learned from doing EUS rendezvous procedures.
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