Modified Rendezvous Technique in Management of Biliary Leak in Right Lobe Live Donor Liver Transplant Recipients

Abstract

Biliary complication is the Achilles' heel for live donor liver transplant. Bile leak is particularly difficult to manage as the anastomotic site was often angled acutely. We described a patient with bile leak managed by a modified rendezvous technique whereby the endoscopist and radiologist work simultaneously under fluoroscopy. Unlike the traditionally described rendezvous technique where the grasping of guidewire occurred at the duodenum, the grasping of guidewire occurred at the biloma in this modified technique. Insertion of biliary stent could then be performed over the guidewire through the duodenoscope. The bile leak resolved after keeping the biliary stents in situ for 12 months.

Non‐operative repair of a transected bile duct using an endoscopic‐radiological rendezvous procedure

“…In previously reported case, the combined stenting procedure was followed by an elective open hepaticojejunostomy . Our technique was also novel that the stents were placed endoscopically in a retrograde fashion, rather than from a percutaneous approach as previously reported . Complete CBD transection can be successfully managed non‐surgically using a combined radiological and endoscopic approach.…”