{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:06:36Z","timestamp":1776470796153,"version":"3.51.2"},"reference-count":27,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,11,29]],"date-time":"2020-11-29T00:00:00Z","timestamp":1606608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The selection of an approach route in endoscopic ultrasound-guided rendezvous (EUS-RV) for failed biliary cannulation is complicated. We proposed an algorithm for EUS-RV. Methods: We retrospectively evaluated consecutive EUS-RV cases between April 2017 and July 2020. Puncturing the distal extrahepatic bile duct (EHBD) from the duodenal second part (D2) (DEHBD\/D2 route) was attempted first. If necessary, puncturing the proximal EHBD from the duodenal bulb (D1) (PEHBD\/D1 route), puncturing the left intrahepatic bile duct (IHBD) from the stomach (LIHBD\/S route), or puncturing the right IHBD from the D1 (RIHBD\/D1 route) were attempted in this order. Results: A total of 16 patients were included. The DEHBD\/D2 route was used in 10 (62.5%) patients. The PEHBD\/D1 route was attempted in five (31.3%) patients, and the biliary puncture failed in one patient in whom the RIHBD\/D1 route was used because of tumor invasion to the left hepatic lobe. The LIHBD\/S route was applied in one (6.3%) patient. Successful biliary cannulation was achieved in all patients eventually. The time from the puncture to the guidewire placement in the DEHBD\/D2 route (3.5 min) was shorter than that in other methods (14.0 min) (p = 0.014). Adverse events occurred in one (6.3%) patient with moderate pancreatitis. Conclusions: The proposed algorithm might be useful for the selection of an appropriate approach route in EUS-RV.<\/jats:p>","DOI":"10.3390\/jcm9123879","type":"journal-article","created":{"date-parts":[[2020,11,29]],"date-time":"2020-11-29T21:55:31Z","timestamp":1606686931000},"page":"3879","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["A Proposed Algorithm for Endoscopic Ultrasound-Guided Rendezvous Technique in Failed Biliary Cannulation"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8182-3524","authenticated-orcid":false,"given":"Saburo","family":"Matsubara","sequence":"first","affiliation":[{"name":"Saitama Medical Center, Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama 350-8550, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keito","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Saitama Medical Center, Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama 350-8550, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Suda","sequence":"additional","affiliation":[{"name":"Saitama Medical Center, Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama 350-8550, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Saitama Medical Center, Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama 350-8550, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Isayama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yousuke","family":"Nakai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Oka","sequence":"additional","affiliation":[{"name":"Saitama Medical Center, Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama 350-8550, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3387-2561","authenticated-orcid":false,"given":"Sumiko","family":"Nagoshi","sequence":"additional","affiliation":[{"name":"Saitama Medical Center, Department of Gastroenterology and Hepatology, Saitama Medical University, Saitama 350-8550, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.4253\/wjge.v11.i1.5","article-title":"Difficult biliary cannulation: Historical perspective, practical updates, and guide for the endoscopist","volume":"11","author":"Berry","year":"2019","journal-title":"World J. 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