Calvo M M, Bujanda L, Heras I, Cabriada J L, Bernal A, Orive V, Miguelez J
Department of Gastroenterology, Galdakao Hospital, Vizcaya, Spain.
Gastrointest Endosc. 2001 Oct;54(4):511-3. doi: 10.1067/mge.2001.118441.
The rendezvous technique combines endoscopy with percutaneous transhepatic cholangiography to facilitate cannulation of the bile duct when previous attempts have failed.
Over a 7-year period, a total of 1753 ERCPs were performed. Twelve of these patients with a diagnosis of choledocholithiasis were poor candidates for surgery. Percutaneous transhepatic cholangiography as well as ERCP with precut papillotomy failed to resolve biliary obstruction. In a further 2 cases the percutaneous approach was used by means of a T-tube positioned at a prior cholecystectomy.
The combined procedure was successful in 13 patients (93%). It was unsuccessful in 1 patient because of a stone lodged distally near the papilla. There was only 1 complication (7%), a retroperitoneal perforation that occurred during papillotomy; no mortality was directly attributable to the technique.
The rendezvous technique is recommended for patients who are not eligible for surgery when ERCP is unsuccessful and when it is impossible to resolve biliary obstruction by percutaneous transhepatic cholangiography.
会师技术将内镜检查与经皮肝穿刺胆管造影相结合，以便在先前的插管尝试失败时便于胆管插管。
在7年的时间里，共进行了1753例内镜逆行胰胆管造影（ERCP）。其中12例诊断为胆总管结石的患者不适合手术。经皮肝穿刺胆管造影以及内镜下乳头预切开术均未能解除胆道梗阻。另外2例患者通过先前胆囊切除术中放置的T管采用经皮途径。
联合手术在13例患者中成功（93%）。1例患者因结石嵌顿在乳头附近远端而手术失败。仅发生1例并发症（7%），为乳头切开术期间发生的腹膜后穿孔；无直接因该技术导致的死亡。
对于不适合手术、ERCP失败且无法通过经皮肝穿刺胆管造影解除胆道梗阻的患者，推荐采用会师技术。
