Pneumoperitoneum Caused by Air Leakage Through the Percutaneous Puncture Tract as a Complication of Rendezvous Technique: A Case Report

The rendezvous technique, combining percutaneous and endoscopic procedures, is a safe and effective method to achieve biliary cannulation if an endoscopic approach fails. The two procedures in this technique can be carried out simultaneously or in stages. A simultaneous approach is reported to be associated with fewer complications, and patients undergoing this approach can recover and be discharged more rapidly. Here, we report a complication of pneumoperitoneum in a patient who underwent percutaneous and endoscopic procedures simultaneously for the removal of a common bile duct stone. It was supposed that prolonged air insufflation during endoscopy forced intestinal air to track into the peritoneal cavity through the bile ducts and the puncture tract. Accordingly, a short wait before removing the percutaneous catheter to deflate the intestinal air will be helpful to avoid such a complication.

Key Words:  endoscopic retrograde cholangiography , percutaneous transhepatic cholangiography , pneumoperitoneum , rendezvous technique

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