Percutaneous-Endoscopic Rendezvous Technique for Treatment of Malignant Biliary Obstruction in a Gastric Cancer Patient after Billroth II Gastrectomy

Gastric cancer is the fifth most commonly diagnosed cancer in the world, with a peak incidence rate at 60 years of age and men affected more than women. Obstructive jaundice is a rare symptom associated with gastric cancer, with a prevalence rate of 2.3%. Management of obstructive jaundice through endoscopic retrograde cholangiopancreatography (ERCP) may be challenging in patients with an altered anatomy, such as a previous history of having undergone a Billroth II. As such, rendezvous techniques of ERCP and percutaneous transhepatic biliary drainage (PTBD) that enter one location through two access points can be used to alleviate the complexities of altered anatomy due to previous abdominal surgery of which ERCP alone was technically difficult and often unsuccessful in problematic conditions. In this case report we present a case of a male with a previous history of a rendezvous technique with ERCP and PTBD, following a Billroth II gastrectomy, and successful stent implantation without any complication.