ERCP by laparoscopic transgastric access and cholecystectomy at the same time in a patient with gastric bypass who was seen with choledocholithiasis

Badaoui, Abdenor; Malherbe, V.; Rosière, Alain; Ronde, Thierry De

doi:10.1016/j.gie.2009.06.031

Cited by 16 publications

(6 citation statements)

References 7 publications

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“…The gastrotomy should be made as lateral as possible along the greater curvature to permit smooth intubation of the pylorus. A 15 mm or 18 mm laparoscopic trocar is used to allow gentle maneuvering of the duodenoscope into the gastric remnant 15 16 17 . However, careless retraction of the endoscope in an angulated position can result in “peeling” of the coating of the duodenoscope ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography in bariatric Roux-en-Y gastric bypass patients

et al. 2015

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Background: Performing endoscopic retrograde cholangiopancreatography in bariatric patients who underwent Roux-en-Y gastric bypass surgery is challenging due to the long anatomical route required to reach the biliopancreatic limb. Aim: Assessment of the feasibility and performance of laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography. Methods: A retrospective multicenter observational consecutive-patient cohort study of all patients in the period May 2008 to September 2014 with a history of Roux-en-Y gastric bypass who presented with complicated biliary disease and who underwent a laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography. The laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography procedure was similar in all centers and was performed through a 15 mm or 18 mm trocar that was inserted in the gastric remnant. Cholecystectomy was performed concomitantly when indicated. Results: In total, 23 patients underwent a laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography procedure. Two patients required a mini-laparotomy for transgastric access because of a complex surgical history resulting in multiple adhesions. Indications included ascending cholangitis, choledocholithiasis, and biliary pancreatitis. Of the 23 patients, 13 underwent concomitant cholecystectomy. All patients successfully underwent biliary cannulation and sphincterotomy. No endoscopic procedure-related complications (i. e. bleeding, pancreatitis or retroperitoneal perforation) occurred. Mean hospital stay was 2.8 days (range 2 – 4). Conclusions: Transgastric endoscopic retrograde cholangiopancreatography is a feasible approach in the treatment of pancreaticobiliary disease in Roux-en-Y gastric bypass patients, without major complications in our series and allows endoscopic treatment and cholecystectomy to be performed consecutively in a single procedure. In Roux-en-Y gastric bypass patients without a history of prior cholecystectomy presenting with complicated gallstone disease, combining cholecystectomy and transgastric endoscopic retrograde cholangiopancreatography as a first-line approach may be a valid treatment strategy.

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Section: Discussionmentioning

confidence: 99%

Laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography in bariatric Roux-en-Y gastric bypass patients

et al. 2015

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“…Laparoscopic access to the biliary tract has the advantage of allowing ERCP and cholecystectomy to be performed in the same setting which has only been case reported, 20 an advantage over balloon-assisted ERCP in the patient who also requires cholecystectomy. We believe that intraoperative endoscopy is more difficult from the physician and nurses' perspective.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Assisted ERCP in Roux-en-Y Gastric Bypass (RYGB) Surgery Patients

Saleem

Levy

Petersen

et al. 2012

Journal of Gastrointestinal Surgery

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“…57, 58, 59, 60, 61, 62, 63 Once again the optimal approach is via translaparoscopic gastroscopic passage through an operatively place trocar directly into the remnant stomach. 57, 61 In this instance, a sterilized duodenoscope is passed under observation in the operative field directly through the trocar and rapidly through the pylorus into the second portion of the duodenum (Figure 5). If necessary, the patient can be placed transiently in a decubitus position although with minor modification a supine position on the operative table is satisfactory.…”

Section: Surgical Options For Morbid Obesity—multidisciplinary Approamentioning

confidence: 99%

Morbid Obesity—The New Pandemic: Medical and Surgical Management, and Implications for the Practicing Gastroenterologist

Cello

Rogers

2013

Clinical and Translational Gastroenterology

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The gastroenterologist, whether in academic or clinical practice, must face the reality that an increasingly large percentage of adult patients are morbidly obese. Morbid obesity is associated with significant morbidity and mortality including enhanced morbidity from cardiovascular, cerebrovascular, hepatobiliary and colonic diseases. Most of these associated diseases are actually preventable. Based on the 1991 NIH consensus conference criteria, for most patients with a body mass index (BMI=weight in kilograms divided by the height in meters squared) of 40 or more, or for patients with a BMI of 35 or more and significant health complications, surgery may be the only reliable option. Currently in the United States, over 250,000 bariatric surgical procedures are being performed annually. The practicing gastroenterologist in every community, large and small, must be familiar with the various surgical procedures together with their associated anatomic changes. These changes may dramatically increase the prevalence of nutritional deficiencies and profoundly alter the clinical and endoscopic approaches to diagnosis and management.

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ERCP by laparoscopic transgastric access and cholecystectomy at the same time in a patient with gastric bypass who was seen with choledocholithiasis

Cited by 16 publications

References 7 publications

Laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography in bariatric Roux-en-Y gastric bypass patients

Laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography in bariatric Roux-en-Y gastric bypass patients

Laparoscopic Assisted ERCP in Roux-en-Y Gastric Bypass (RYGB) Surgery Patients

Morbid Obesity—The New Pandemic: Medical and Surgical Management, and Implications for the Practicing Gastroenterologist

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