ArticleEndoscopy international open2026
Endoscopic ultrasound-guided rendezvous vs precut for difficult biliary cannulation: Updated meta-analysis.
Article in Endoscopy international open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
12 authors.
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Abstract
Background and study aims: Difficult biliary cannulation (DBC) remains a significant challenge in endoscopic retrograde cholangiopancreatography (ERCP). When cannulation fails, precut techniques are widely used as rescue techniques. Endoscopic ultrasound-guided rendezvous (EUS-RV) is increasingly used by experts as an alternative to precut for cannulating the bile duct. However, there is limited literature comparing these two techniques. This systematic review and meta-analysis aimed to compare effectiveness and safety of EUS-RV versus precut techniques for biliary access in DBC. Patients and methods: A systematic search was conducted across PubMed, Embase, and Cochrane Library databases up to April 2025. Studies comparing EUS-RV and precut techniques in adult patients with DBC were included. Data were pooled using a random-effects model. Primary outcome was technical success rates; secondary outcome was adverse event (AE) rates. Results: Five studies (two randomized controlled trials and three retrospective cohorts) comprising 875 patients were included. Pooled technical success was higher with EUS-RV compared with precut (95.9% vs. 91.4%; relative risk [RR] 1.06; 95% confidence interval [CI] 1.00-1.12; Conclusions: EUS-RV is associated with higher technical success rates compared with precut techniques for rescue biliary cannulation after failed standard ERCP, with a comparable safety profile. These findings suggest that EUS-RV may represent at least a valuable alternative rescue strategy when expertise is available; however, further trials are needed to assess its safety, procedure duration, and learning curve.
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