Schreuder AM, et al. - Here, the researchers evaluated short- and long-term outcomes of the rendezvous procedure for the management of bile duct injuries (BDI) after cholecystectomy. With a long-term success rate of 55%, rendezvous was found to be a safe procedure in experienced hands. Rendezvous ought to be considered, either as definitive treatment or as a bridge to elective surgery when endoscopic or transhepatic interventions failed to restore bile duct continuity in patients with BDI.

Methods

• The researchers examined all consecutive patients with BDI referred to their tertiary referral center between 1995 and 2016.
• They performed a rendezvous procedure when endoscopic or radiologic intervention failed, and when deemed feasible by a dedicated multidisciplinary team including hepatopancreaticobiliary surgeons, gastrointestinal endoscopists, and interventional radiologists.
• They evaluated classification of BDI, technical success of the rendezvous procedure, procedure-related adverse events, and outcomes.

Results

• The researchers performed rendezvous in 47 patients (6%) among a total of 812 patients.
• Out of 47 patients, 31 (66%) were diagnosed with complete transection of the bile duct (Amsterdam type D/Strasberg type E injury).
• In this study, the primary success rate of rendezvous was 94% (44/47 patients).
• Overall morbidity was 18% (10/55 procedures).
• They observed no life-threatening adverse events or 90-day mortality.
• Rendezvous was the final successful treatment in 26/47 patients (55%) after a median follow-up of 40 months (interquartile range 23-54 months).
• Rendezvous acted as a bridge to surgery in 14/47 patients (30%), with hepaticojejunostomy being chosen either primarily or secondarily to treat refractory or relapsing stenosis.