A modified Rendezvous ERCP technique in duodenal diverticulum

Figure 1 A sterile guide-wire was inserted via the T-tube to the common bile duct stone then to the papilla. A: Retained stone with a T-tube in the common bile duct; B: The antegrade insertion of a guide-wire through the T-tube; C: The extension of the guide-wire through the papilla into the duodenum.

Figure 2 Schematic diagram of a guide-wire.

Figure 3 Appearance of the technique. A: A guide-wire through the papilla during an endoscopic sphincterotomy; B: The guide-wire taken out by a snare; C: The guide-wire inserted in the tip of the sphincterotome, which is inserted via the endoscope channel of the duodenoscope; D: The stone is extracted by a basket catheter.

Figure 4 Control images of the common bile duct stone after the extraction of the stone.