EUS-guided biliary rendezvous using a short hydrophilic guidewire.

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 eUsguided 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.