Laparoscopic Gastric Access for Endoscopic Retrograde Cholangiopancreatography (ercp) Following Roux-en-Y Gastric Bypass (rygb)

Patients who have undergone roux-en-y gastric bypass may require upper endoscopic evaluation for a variety of reasons which may or may not be related to their surgical procedure. The ability to access the remnant stomach or biliary tree by the traditional transoral route may be only possible through specialized endoscopic or percutanous procedures, or even laparotomy due to the altered foregut anatomy. The following video demonstrates a method of accessing the gastric remnant and performing percutaneous Endoscopic Retrograde Cholangiopancreatography (ERCP) through a laparoscopic gastrostomy. Such an approach provides access to the papilla without the need for specialized equipment. In our particular patient, cholangiography and sphincterotomy were required for Sphincter of Oddi dysfunction; however, the approach could also be used to evaluate the biliary tree for evaluation of a multitude of either benign or malignant pathologies.

Session: Podium Video Presentation

Program Number: V028

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