Hepatobiliary · IR Playbook

Percutaneous–Endoscopic Biliary Rendezvous Procedure (PE-RV)

Percutaneous–endoscopic biliary rendezvous is a combined interventional radiology and endoscopic salvage procedure in which an antegrade guidewire is advanced through percutaneous transhepatic biliary access, across the papilla or bilioenteric anastomosis, and used to facilitate retrograde endoscopic biliary cannulation. It is primarily used after failed ERCP when urgent or definitive internal biliary drainage is required and may also restore continuity across postoperative strictures or bile duct injuries. Reported technical success is approximately 80–95% depending on the indication and anatomy; the 2025 World Endoscopy Organization analysis of failed-cannulation studies reported 95% pooled technical success with a heterogeneous 23% overall adverse-event rate.

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