How to Access the Gastric Remnant for Management of CBD Stones – Endoscopically and Surgically

Presented by Samuel Szomstein, MD at the SAGES 2014 Meeting; Panel – Endoscopic Management of Bariatric Complications

---

epidemiology with citation –1:00 https://www.ncbi.nlm.nih.gov/pubmed/?term=9731681
obesity management with citation–1:24 https://www.ncbi.nlm.nih.gov/pubmed/?term=23177371
effect of RYGB with citati

---

Keyword(s): abdominal CT scan, acute cholecystitis, American population, ampulla, ampulla cannulation, antegrade, antegrade ERCP, asymptomatic, asymptomatic cholelithiasis, bariatric patient, bariatric patients, bariatric procedure, bile, bile leak, biliary complication, biliary disease process, biliary stricture, biliary stricture and dilatation, case report, cholangiogram, cholangitis, cholecystitis, choledocolithiasis, cholelithiasis, cholesterolosis, chronic cholecystitis, chronic RUQ pain, clinical dx, colic, collection of fluid, combined work, complete resolution, complicated postop course, complications, concurrent cholecystectomy, consultant, Covidien, current case series, cystic approach, deferred chole, dilema, diseased GB, drugs, elective laparoscopic ante-colic, ante-gastric RYGB, endoscopic management of bariatrics complications, endoscopist, epidemiology, ERCP, Ethicon Endosurgery, evaluation, evidence of disease, extravasation of contrast, female, first attempt, follow up, G-tube, gallbladder disease, gallbladder in situ, gallstone formation, gallstones, gastric bypass, gastroenterologists, gastrostomy, GB, impacted stone, infection rate, inflammation, international bariatric surgical registry, IR placed G-tube, jaundice, lap assisted placed G-tube, lap assisted transgastric endoscopy, lap CBDE, lap transgastric ERCP, laparoscopic TCDCBDE, laparoscopic transgastric ERCP, late complications, lead time, leak, leukocytosis, literature, liver bed, low-grade fever, management of biliary disease, management of biliary tract disease, mean age, mean BMI, mean LOS, mean operative time, mild tachycardia, MIS, morbid obesity, morbidly obese, morbidly obese population, neck, negative US, normal GB, obesity management, open CBDE, open or laparoscopic approach, oversew, pancreatitis, passed the scope, pathology, percutaneous CT, peritonitis, post chole, posterior aspect of remnant, posterior wall, pre-bariatric surgery cholecystectomy, preop dx, preop work-up, prevalence, previous hx, prolonged, prophylactic cholecystectomy, prophylactically, prospectively collected data, published, push enteroscopy, rapid wt loss, recommendations, repeat cholangiogram, resolved, results, retrograde, retrospective, retrospective review, risk for, routine cholecystectomy, routine surgery, RYGB, RYGBP chole, safe and useful approach, SAGES poster presentation 2005, short gastrics, significance, significant for a leak, silent gallstones, simultaneous chole, simultaneous use of endoscope, single indication, single institution, single or double balloon enteroscopy, single stage, sleeve gastrectomy, sludge, SOD, speaker, sphincterotomy, spiral endoscopy, staged fashion, standard of care, stent placement, stenting, sterile scope, stomach, strictures, success rate, surgical transduodenal pancreatic sphincteroplasty, symptomatic, technique, tortuous, trans remnant ERCP, trans-gastric endoscopy, transduodenal sphincterotomy, transgastric ERCP, transgastrostomy ERCP after a RYGB, trocars, U.S., ultrasonographically normal, uneventful surgery, Ursoidol therapy, US guided access of the remnant, wall thickening, warrant removal, worsening abdominal pain, wound infections