cqvip:Background:Biliary access at ERCP rendezvous is usually achieved by withdrawing a wire passed antegrade via the accessory channel of the duodenoscope,which is then used for over-the-wire cannulation.The wire is time consuming to maneuver and may be damaged during withdrawal.Objective:Description of a simple technique for cannulation at rendezvous that overcomes these problems.Design:Observational study.Setting:Gastroenterology department of a teaching district general hospital.Patients:Fourteen consecutive patients undergoing rendezvous after percutaneous transhepatic cholangiography(PTC).Intervention:A transpapillary drain was placed at PTC in 13 patients.At rendezvous,cannulation alongside the drain was attempted with a sphincterotome cannula.After successful cannulation,the drain was progressively withdrawn,allowing retrograde therapeutic intervention.Results:In all 13 patients,parallel cannulation was successful,allowing stone removal or biliary stent placement,with cannulation alongside a guidewire in the fourteenth patient.There were no complications except right hypochondrial pain after drain removal.Conclusions:Parallel cannulation is straight forward and effective,avoiding the need for guidewire manipulation.
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