Abid C Mogannam, MD, MBA, Renzo Garberoglio, MD, Esther Wu, MD, Daniel Srikureja, MD, Vincent Kao, DO, Stephanie Keeth, MSN, Carlos Garberoglio, MD, FACS, Marcos Michelotti, MD, Matthew Oman, MD, Keith Scharf, DO, FACS. Loma Linda University Health
Patients with biliary obstruction after a Roux-en-Y gastric bypass present a challenge for endoscopic management due to the anatomic re-arrangements. The incidence of primary bile duct stones has been documented to be 10% in overall. Laparoscopic-assisted trans-gastric ERCP is a technique well documented in the literature to treat this entity. In this video, we present our method to treat primary bile duct stones status post Roux-en-Y gastric bypass. The technique remains a safe and effective approach in this clinical scenario.