Troubleshooting of Endoscopic Ultrasound-guided Rendezvous Using a Nasobiliary Drainage Tube.

ABSTRACT: Endoscopic ultrasound-guided rendezvous (EUS-RV) is an alternative technique for patients in whom selective bile duct cannulation (SBDC) has failed during endoscopic retrograde cholangiopancreatography (ERCP). However, EUS-RV has several challenging steps. Herein, we present a method for troubleshooting the EUS-RV using a nasobiliary drainage tube (NBD) in a patient with a large periampullary diverticulum (PAD) and severe gastroptosis. An 80-year-old woman presented with nausea. Contrast-enhanced computed tomography revealed a common bile duct (CBD) stone. Although ERCP was performed twice, the ampulla of Vater (AV) could not be identified due to the large PAD. Therefore, EUS-RV was performed. The CBD was punctured from the descending part of the duodenum. Although a guidewire was advanced

SUBMITTER: Yamazaki T 

PROVIDER: S-EPMC12580290 | biostudies-literature | 2026 Apr

REPOSITORIES: biostudies-literature