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Performing endoscopic retrograde cholangiopancreatography (ERCP) in patients with a prior Roux-en-Y gastric bypass (RYGB) has historically been challenging because the normal route for duodenoscope passage has been eliminated surgically. In the past, procedural options included balloon enteroscopy, which is time-consuming and has a high technical failure rate, and laparoscopically assisted ERCP, which has a high success rate but requires significant resources, personnel, and time.
Recently, a new technique was developed whereby a lumen-apposing metal stent (LAMS) is used to make a transluminal conduit between the gastric pouch and the remnant stomach, allowing ERCP to be performed through the conduit and obviating the need for balloon entero…