A 60-year-old male developed symptomatic pancreatic duct stricture due to pancreatic metastasis from lung cancer. Transpapillary pancreatic duct drainage was challenging; hence, pancreatic duct drainage was successfully performed using the endoscopic ultrasonography-guided rendezvous procedure (EUS-RV). The guidewire was navigated to the duodenum, beyond the stricture site in the main pancreatic duct. The procedure was successful as the guidewire was maintained in a U-shape by securing the distance between the puncture and pancreatic stricture sites. By replacing the catheter with a tapered one, guidewire seeking was simplified. However, the EUS-RV technique requires advanced skills. It is important to note that completing the procedure often requires more than one session. The formation of a pancreatic duct-gastrointestinal fistula should be prioritized; transpapillary stent placement can be performed through RV route later.
