ASGE DDW Videos from Around the World | 2026-COMBINED ENDOSCOPIC RETROGRADE AND ENDOSONOGRAPHY-GUIDED (CERES) CHOLANGIOGRAPHY WITH A WIRELESS RENDEZVOUS APPROACH

COMBINED ENDOSCOPIC RETROGRADE AND ENDOSONOGRAPHY-GUIDED (CERES) CHOLANGIOGRAPHY WITH A WIRELESS RENDEZVOUS APPROACH

Video Transcription

Video Summary

A 70-year-old woman with metastatic perihilar cholangiocarcinoma and severe obstructive jaundice underwent repeated failed ERCP attempts for biliary drainage. The team then performed EUS-guided hepaticogastrostomy to access the left hepatic system and advanced a guidewire across the hilar stricture into the duodenum, creating a wireless rendezvous pathway. This enabled successful transpapillary stenting of the right hepatic system with serial metal stents. Bilirubin normalized by 4 weeks, and she remained stable at 6 months while receiving palliative chemotherapy. The case demonstrates that wireless rendezvous can salvage failed ERCP and achieve effective bilateral biliary drainage.

Asset Subtitle

Endoscopy in Action
Mohamed Tausif Siddiqui

Keywords

metastatic perihilar cholangiocarcinoma

obstructive jaundice

EUS-guided hepaticogastrostomy

wireless rendezvous

bilateral biliary drainage