Percutaneous cholangioscopy-assisted rendezvous endoscopic retrograde cholangiography technique for a difficult postliver transplant anastomotic stricture.

Background And Aims: In cases of postliver transplant biliary stricture with double-duct anastomsis, double-duct stenting is absolutely necessary to preserve graft function.

Methods: We present a successful technique of percutaneous cholangioscopy-assisted rendezvous ERCP for difficult anastomotic stricture after failure of cholangioscopy-guided wire negotiation and percutaneous transhepatic biliary drainage.

Results: We achieved successful completion of biliary drainage through right anterior sectoral duct and right posterior duct stenting with subsequent dilatation of the stricture. There was resolution of the anastomotic stricture on follow-up.

Conclusions: Cholangioscopy-assisted rendezvous endoscopic retrograde cholangiography technique is a reasonable option for a difficult post-transplant anastomotic stricture when conventional methods fail.