On Hospital in Busan Successfully Performs Innovative Rendezvous Procedure

Recently, the On Hospital in Busan successfully performed the complex Rendezvous procedure. This treatment offers new hope to patients suffering from bile duct and gallbladder cancer. Biliary cancer, in particular, is a difficult-to-treat disease affecting approximately 8,000 people annually in Korea, often found in the elderly. Due to its subtle initial symptoms, early detection is challenging, and it predominantly affects individuals aged 70 and above.

Treating Biliary Diseases: The Necessity of the Rendezvous Procedure

Biliary diseases are typically treated with Endoscopic Retrograde Cholangiopancreatography (ERCP). However, when the bile duct opening is completely blocked due to cancer or severe inflammation, even an endoscope guide wire cannot be inserted, leading to procedure failure. In such cases, patients may face the risky necessity of undergoing open surgery.

At On Hospital in Busan, a collaborative team from the Department of Gastroenterology and Radiology successfully performed the Rendezvous procedure on a high-risk 60-year-old patient with biliary stenosis. This procedure involves simultaneously utilizing pathways from both the skin and the mouth to unblock the obstructed passage, functioning as a bidirectional approach.

The Process of the Rendezvous Procedure

The Rendezvous procedure was executed through precise collaboration between two key components. Initially, Dr. Choi Ki-bok, Director of Radiology, inserted a guide wire through the patient's right flank into the bile duct within the liver using Percutaneous Transhepatic Biliary Drainage (PTBD). This guide wire was then passed through the blocked bile duct into the duodenum. Subsequently, Dr. Hwang Jong-ho from Gastroenterology inserted an endoscope via the duodenum (ERCP) to grasp the end of the guide wire, thereby establishing a bidirectional pathway.

Once the access route was open, the medical team accurately collected tissue samples from the suspected cancerous area and placed a biliary stent to ensure proper bile flow. The Rendezvous procedure offers the significant advantage of treating patients non-invasively, without the need for open surgery.

On Hospital's Medical Services: Hope for Local Patients

The Rendezvous procedure is a highly complex technique primarily performed at large hospitals in Seoul. Therefore, its successful completion by a regional comprehensive secondary general hospital, solely through its own multidisciplinary collaborative system, is a rare achievement. Since establishing its Pancreas and Biliary Center in 2021, On Hospital has surpassed 3,000 cumulative ERCP procedures, accumulating clinical experience comparable to university hospitals.

Dr. Choi Ki-bok and Dr. Hwang Jong-ho stated, "It is deeply meaningful to have opened a safe treatment path for patients with intractable biliary stenosis, where conventional endoscopic access was impossible." They added, "We will do our utmost to ensure that local patients can receive top-tier medical services without having to travel to the Seoul metropolitan area."