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Approaches to Pancreaticobiliary Endoscopy in Roux-en-Y Gastric Bypass Anatomy.

Khaled ElfertMichel Kahaleh
Published in: Gastrointestinal endoscopy clinics of North America (2024)
The increasing prevalence of bariatric surgery, particularly Roux-en-Y gastric bypass, has necessitated innovative approaches for endoscopic retrograde cholangiopancreatography (ERCP) due to the altered anatomy. Laparoscopy-assisted ERCP offers high success rates but leads to extended hospital stays and an increased risk of adverse events. Enteroscopy-assisted ERCP encounters technical challenges, resulting in lower success rates. A novel technique, endoscopic ultrasound-directed transgastric ERCP, employs a lumen-apposing metal stent to create a fistula connecting the gastric pouch to the excluded stomach, enabling ERCP and other endoscopic procedures. Common adverse events include perforation, stent migration, bleeding, and fistula persistence.
Keyphrases
  • roux en y gastric bypass
  • ultrasound guided
  • weight loss
  • bariatric surgery
  • obese patients
  • gastric bypass
  • healthcare
  • magnetic resonance imaging
  • risk factors
  • computed tomography
  • robot assisted