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Endoscopic retrograde cholangiopancreatography (ERCP) in patients who have undergone prior Roux-en-Y gastric bypass (RYGB) remains a common and vexing problem for gastroenterologists. One approach to this problem is laparoscopy-assisted ERCP (LA-ERCP), whereby a surgeon creates a transcutaneous route to the excluded stomach through which a duodenoscope can be inserted to reach the major papilla. Another approach is balloon enteroscopy-assisted ERCP (BAE-ERCP), whereby a special enteroscope can reach the major papilla via the esophagus, gastric pouch, and surgically reconstructed small bowel.
To compare these two approaches, investigators in Norway reviewed 79 ERCP procedures (39 were LA-ERCP and 40 were BAE-ERCP) in 68 RYGB patients.
Clinical…