Endoscopic Ultrasound-Guided Rendezvous Procedure for a Nondilated, Leaking Pancreatic Duct

Abstract

Pancreatic duct (PD) leak leading to pancreatic ascites is a serious complication of chronic pancreatitis. Endoscopic management with endoscopic retrograde cholangiopancreatography (ERCP) has been found to be successful; however, if selective cannulation of the PD is unsuccessful, an endoscopic ultrasound–guided rendezvous procedure can help in bridging PD leaks, provided the duct is dilated. We report a successful endoscopic ultrasound–guided rendezvous procedure in a patient with PD leak, pancreatic ascites, and a nondilated duct with failed ERCP who was a poor candidate for surgery. The pancreatic ascites resolved following the procedure.

Double-balloon enteroscopy with EUS-guided rendezvous for failed cannulation in patients with history of Roux-en-Y gastric bypass

“…Considering the distal CBD stricture, retrograde access to the CBD using a needle knife was not considered to be feasible. 1 , 2 It was hence decided to proceed with EUS-guided rendezvous biliary access. Using a curvilinear echoendoscope, we obtained a cholangiogram that revealed a dilated CBD with filling defects and a distal CBD benign appearing stricture.…”

EUS-guided pancreatic rendezvous for management of pancreaticopleural fistula with an undilated duct and pancreas divisum

“…Only one case report describes EUS RV in a patient with undilated PD and chronic pancreatitis with pancreatic ascites. [ 4 ] We were able to achieve access of the undilated PD in our patient with EUS guidance and subsequently bridge the pancreatic leak.…”