As more individuals undergo Roux-en-Y gastric bypass (RYGB), more medical providers
encounter the positive and negative consequences of surgically altered intestinal
anatomy. The configuration of a RYGB impairs transoral endoscopic access to the remnant
stomach, duodenum, and biliary tree. This complicates the diagnosis and treatment
of pathology localized to these excluded anatomic regions, such as ulcers, sources
of bleeding, malignancies, and biliary obstructions [
1
,
2
]. Furthermore, RYGB often results in rapid weight reduction, which is associated with
the development of cholelithiasis that may progress to choledocholithiasis, a condition
conventionally treated with transoral endoscopic retrograde cholangiopancreatography
(ERCP) [
[3]
]. Thus, RYGB concurrently increases the probability of developing choledocholithiasis
and decreases the probability that minimally invasive treatments of this condition
will be successful.To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 07, 2017
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© 2017 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
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- Systematic review of transgastric ERCP in Roux-en-Y gastric bypass patientsSurgery for Obesity and Related DiseasesVol. 13Issue 7
- PreviewBalloon-assisted endoscopic retrograde cholangiopancreatoscopy (ERCP) in Roux-en-Y gastric bypass (RYGB) patients is technically challenging due to anatomic and accessory constraints, thus success rates are modest. Transgastric ERCP (TG-ERCP) offers a viable alternative. We aimed to systematically review the literature on TG-ERCP in RYGB patients to better define the technical approaches, success rates, and adverse events of this procedure. A computer-assisted search of the Embase and PubMed databases was performed to identify studies that focused on the techniques and clinical outcomes of TG-ERCP.
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