title: Comparative study of rendezvous techniques in post-liver transplant biliary stricture.
abstract: OBJECTIVE
  To investigate the usefulness of a new rendezvous technique for placing stents using the Kumpe (KMP) catheter in angulated or twisted biliary strictures.
  
  
  METHODS
  The rendezvous technique was performed in patients with a biliary stricture after living donor liver transplantation (LDLT) who required the exchange of percutaneous transhepatic biliary drainage catheters for inside stents. The rendezvous technique was performed using a guidewire in 19 patients (guidewire group) and using a KMP catheter in another 19 (KMP catheter group). We compared the two groups retrospectively.
  
  
  RESULTS
  The baseline characteristics did not differ between the groups. The success rate for placing inside stents was 100% in both groups. A KMP catheter was easier to manipulate than a guidewire. The mean procedure time in the KMP catheter group (1012 s, range: 301-2006 s) was shorter than that in the guidewire group (2037 s, range: 251-6758 s, P = 0.022). The cumulative probabilities corresponding to the procedure time of the two groups were significantly different (P = 0.008). The factors related to procedure time were the rendezvous technique method, the number of inside stents, the operator, and balloon dilation of the stricture (P < 0.05). In a multivariate analysis, the rendezvous technique method was the only significant factor related to procedure time (P = 0.010). The procedural complications observed included one case of mild acute pancreatitis and one case of acute cholangitis in the guidewire group, and two cases of mild acute pancreatitis in the KMP catheter group.
  
  
  CONCLUSIONS
  The rendezvous technique involving use of the KMP catheter was a fast and safe method for placing inside stents in patients with LDLT biliary stricture that represents a viable alternative to the guidewire rendezvous technique.
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 137-701, South Korea.
authors.forename: Jae Hyuck
authors.initials: JH
authors.lastname: Chang
authors.forename: In Seok
authors.initials: IS
authors.lastname: Lee
authors.forename: Ho Jong
authors.initials: HJ
authors.lastname: Chun
authors.forename: Jong Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Seung Kyoo
authors.initials: SK
authors.lastname: Yoon
authors.forename: Dong Goo
authors.initials: DG
authors.lastname: Kim
authors.forename: Young Kyoung
authors.initials: YK
authors.lastname: You
authors.forename: Myung-Gyu
authors.initials: MG
authors.lastname: Choi
authors.forename: Sok Won
authors.initials: SW
authors.lastname: Han
mesh_terms: D000328:Adult; D057785:Catheters; D016009:Chi-Square Distribution; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Biliary stricture; Endoscopic retrograde cholangiography; Liver transplantation; Percutaneous transhepatic biliary drainage; Rendezvous