Background: Malignant biliary obstructions, are mainly treated by endoscopic retrograde cholangio-pancreatography (ERCP); but, if ERCP fails, percutaneous transhepatic cholangiography (PTC) remain save approaches regardless of advancements of the recent ERCP technique. Rendezvous technique combines the radiological and endoscopic technique for palliative treatment in cases where the endoscopic techniques have failed.
Methods: This study is a controlled study and was carried out upon (24) patients complaining of malignant biliary obstruction symptoms with failed cannulation by ERCP, between the period from January 2017 and January 2019 in the general surgery department of Zagazig University Hospitals.

Results: The mean age of patients was 55.81± 15.13, range from 35-75. Most of them were males (66.7%). 41.7% of Malignant obstructive jaundice cases caused by pancreatic carcinoma, 33.3% caused by periampullary carcinoma and 25% of them caused by cholangiocarcinoma. Regarding the site of obstruction, more than half of them (62.5%) had distal site of obstruction and 37.5% of them had proximal site of obstruction. Concerning CT, 70% of the studied group had liver nodules and 30 % of them had liver nodules and malignant ascites. In addition to MRCP, all of the studied group (100%) had marked intra hepatic biliary radical dilatation, success rate of rendezvous technique was 91.7% .

Conclusions: Percutaneous-transhepatic-endoscopic rendezvous procedures have high success rates (91.7%). If percutaneous procedure is necessary , RV techniques may approving safety than PTC , and have all the advantages of endoscopy.