Use of the Rendezvous Technique for the Treatment of Acute Cholangitis Caused by Calculi of the Bile Duct

Abstract

While various therapeutic methods have been adopted for choledocholithiasis, it may safely be said that at present, the standard treatment is endoscopic treatment. “ Medical care and treatment guidelines for acute cholangitis and cholecystitis ” have been published for the first time in Japan. According to these guidelines, endoscopic biliary drainage for acute cholangitis is recommended based on evidence level “ A ”. However, interventional endoscopy (IVE) is often very difficult, because it (IVE) requires skill. In some acute cholangitis patients in whom treatment by IVE, particularly insertion of the IVE into the papilla of Vater, was difficult, we used the Rendezvous technique, which combinesinterventional radiology ([IVR], PTCD, and percutaneous transhepatic biliary drainage [PTBD]) with IVE, to conduct successful lithectomy (of the calculi). The purposes of use of the Rendezvous technique for the treatment of acute cholangitis caused by bile duct calculi is to improve the patients' general condition using only one procedure, using a therapeutic method appropriate for the conditions and circumstances available at the facility. The use of this technique allowed noninvasive lithectomy and increased the procedural range of lithectomy. It was considered that the technique contributed to improvement of the patients' quality of life (QOL).