Loading...
In patients with prior Roux-en-Y gastric bypass (RYGB), ERCP is technically challenging, primarily because a standard duodenoscope now can rarely reach the major papilla. Available facilitative options include enteroscope-assisted ERCP, endoscopic ultrasonography (EUS)-guided approaches to access the bile duct, and laparoscopy-assisted ERCP (LA-ERCP), wherein a surgeon enables access to the excluded stomach so that a duodenoscope can attain the major papilla via a transpyloric route. In an international retrospective cohort study involving 579 patients (median age, 51; 84% women) across 34 centers, researchers evaluated the safety and efficacy of LA-ERCP.
Indications for LA-ERCP were biliary in 89% of patients, pancreatic in 8%, and both in …