Rendezvous Technique with the Stent Retriever for Benign Bilial Restricture, Primer Author João Remy de Freita Jr. Co-authors Guilherme H.P. Oliveira, Ana P.S. Coutinda, Marina T.G. Baldavira, Fernanda P. Lojudice, Igor B. Ribeiro, Spencer Shane, Mauricio K. Minata, Eduardo G.H. Demoura These are our disclosures. Case Presentation A 25 year old woman with 2 months history of abdominal pain, jaundice and vomiting. She had a past medical history of a video laparoscopic cholecystectomy 2 years before, C-section in 2015 and class 1 obesity. Her laboratory tests showed total bilirubin of 7.4 and direct bilirubin of 6.9. ERCP findings showing a focal restricture of the confluence of the right and left hepatic duct and failure of the guide wire to pass through the stenosis. A percutaneous transhepatic biliary puncture was performed. During transhepatic puncture there was no progression of the guide wire, so a duodenoscope was introduced to the second duodenal portion. Stenosis was 12 mm from the confluence of the ducts, associated with excess deviation. There was no progression of the 0.035 inches guide wire. Then we can see the guide wire passing through the stenosis using the stent retriever and the needle knife. We used a biliary dilation catheter to dilate the stenosis. Then we performed another dilation with a 8 mm balloon dilator and we can see in fluoroscopy balloon disappearance waste. Right hepatic duct was drained with a pigtail stent. Left hepatic duct was drained with a straight stent. This was the final aspect. The patient was discharged on the seventh day after biliary drainage and improved her symptoms. She returned to the endoscopy unit in two months to change the stents.

abdominal pain

jaundice

laparoscopic cholecystectomy

hepatic ducts

biliary drainage