The aim of the present study is to analyze the technical advantage of the endoscopic-radiologic rendezvous, and evaluate the validity and sustainability of this technique. Methods: From April 2003 to August 2013, we retrospectively enrolled 31 cases of endoscopic-radiologic rendezvous as a rescue for failed conventional ERC. We classified the endoscopic-radiologic rendezvous into 6 different subtypes, and analyzed the technical characteristic buy RO4929097 and usefulness of each technique. Overall technical outcomes

and safety profiles were evaluated. Results: The overall technical success rate of endoscopic-radiologic rendezvous was 91.2% (28/31). In 10 patients with approach failure, successful approach was achieved in Nutlin-3 nmr 7 (70.0%) through the unique approach technique using the traction force produced by pulling antegrade guidewire via percutaneous route. Biliary deep cannulation was achieved in all cases with selective cannulation failure or guidewire passage failure, with the aid of 6 different cannulation techniques, 4 modified techniques of which are difficult or impossible to be applicable in the EUS-guided rendezvous. No adverse event associated with percutaneous transhepatic biliary

drainage was encountered. Conclusion: The endoscopic-radiologic rendezvous is still valid and sustainable as an alternative rescue modality for the failed conventional ERC even in the era of EUS-guided biliary intervention. Key Word(s): 1. rendezvous ERCP Presenting Author: JIN HONG KIM Additional Authors: MIN JAE YANG Corresponding Author: JIN HONG KIM Affiliations: Ajou University Hospital Objective: Early prediction of possible post-ERCP pancreatitis (PEP) could allow for an

earlier safe discharge of a patient on the same day after ERCP. The aim of this study was to investigate a predictive cut-off Pyruvate dehydrogenase lipoamide kinase isozyme 1 value of 4-hour post-ERCP serum amylase and lipase levels for the PEP. Methods: In patients who underwent ERCP procedures and had tests for serum amylase and lipase levels of 4-hour post-ERCP and the next morning at Ajou Medical Center from January 2012 to August 2013, patient demographics, the procedure reasons, performance of pancreatograms, serum amylase and lipase levels were retrospectively evaluated. Results: PEP occurred in 16 (3.1%) after 516 ERCP procedures. Its severity was mild in 4 (25%), moderate in 9 (56.3%), and severe in 3 (18.8%). The mean 4-hour amylase level was significantly higher in patients with PEP, compared with those without PEP (965 U/L vs. 158 U/L, P = 0.001). The sensitivity, specificity and negative predictive value (NPV) of a 4-hour post-ERCP amylase level with a cut-off value of 2.5 times of its normal upper limit (290 U/L) was 75.0%, 88.0% and 99.1%, respectively. The sensitivity, specificity and negative predictive value (NPV) of a 4-hour post-ERCP lipase level with a cut-off value of 8 times of its normal upper limit (480 U/L) was 75.0%, 91.3% and 99.1%, respectively.