Abstract
An 80-year-old female patient who had previously undergone Roux-en-Y hepaticojejunostomy for congenital biliary dilatation was referred to our hospital with a history of jaundice and abdominal pain, and was diagnosed as having hepatolithiasis. Double-balloon enteroscopic retrieval was attempted at first, but failed because the narrowed part of segment II of the intrahepatic biliary duct (IHBD) could not be cannulated. Therefore, we performed percutaneous transhepatic cholangio drainage (PTCD) for the purpose of biliary drainage. A guidewire could be introduced via the PTCD route into the elevated jejunum, and intubation through the narrow part of the bile duct was performed. Then, double-balloon enteroscopy-assisted hepaticolithotomy was performed successfully by the rendezvous method via the PTCD route. The rendezvous method via the PTCD route is useful when selective cannulation of the IHBD is difficult due to the presence of stenosis.
