title: EUS-guided biliary rendezvous using a short hydrophilic guidewire.
abstract: BACKGROUND AND STUDY AIMS: EUS-guided rendezvous technique for biliary access requires expert manipulation of the guidewire across the downstream stricture or papilla. Published literature reports usage of the long-wire system to prevent loss of wire during scope exchange. We studied the efficacy of using a short hydrophilic guidewire in EUS-guided rendezvous.  PATIENTS AND METHODS: This is a retrospective study conducted in a tertiary care referral centre. 15 patients underwent EUS-guided biliary rendezvous with short wire. EUS-guided transduodenal/transgastric puncture of the biliary system was performed, followed by anterograde placement of a hydrophilic short-wire (260 cm) across the downstream stricture and/or papilla. Retrograde access was then achieved by retrieving the trans-papillary wire, followed by standard ERCP intervention. Main outcome measurements were rates of procedural success and complications.  RESULTS: EUS-guided biliary rendezvous was successful in 14 patients (93.3%). Failure was seen in one patient due to a tight malignant biliary stricture. One patient had peri-choledochal bile tracking which did not require any specific treatment.  CONCLUSIONS: Short-wire system in EUS-guided biliary rendezvous is highly effective and safe. It is a useful salvage procedure for biliary cannulation in patients with accessible papilla.
authors.affiliation: Institute of Advanced Endoscopy, Mumbai, India.
authors.forename: Vinay
authors.initials: V
authors.lastname: Dhir
authors.forename: Boon Eu Andrew
authors.initials: BE
authors.lastname: Kwek
authors.forename: Suryaprakash
authors.initials: S
authors.lastname: Bhandari
authors.forename: Mukta
authors.initials: M
authors.lastname: Bapat
authors.forename: Amit
authors.initials: A
authors.lastname: Maydeo