P-THER-23: Maneuver of rendezvous and drainage of biliary track obstructed by papillary tumor

We present the drainage of the biliary tract in a 75-year-old patient with a papillary tumor. In her, it was impossible to perform endoscopic retrograde cholangiopancreatography (ERCP). Steps are as given below: 1. After trying to perform ERCP and cannot do it, we change the duodenoscope by a Fujinon linear endosonograph; 2. We evaluate the dilated biliary track and from the gastric antrum. We achieve punction the biliary track. The puncture is made with a Boston scientific needle 19-gauge; 3. Then, bilis is sucked and we inject a medium of contrast, to see anatomy; 4. Once the anatomy is checked, a hydrophilic guide of 0.035 mm was passed, with special handling directed to the duodenum; 5. At this time, we remove the lineal endosonograph and pass a duodenoscope of side vision. We grasp the hydrophilic guide with a snare and introduce it into the duodenoscope, passing through it a papilotome. Then, we perform a conventional ERCP with a self-expandable stent. Evolution was satisfactory