Laparoscopic transgastric endoscopic retrograde cholangiopancreatography (ERCP) after gastric bypass: case series and a description of technique

Bertin, P.; Singh, K. J.; Arregui, Maurice E.

doi:10.1007/s00464-011-1593-5

Cited by 68 publications

(38 citation statements)

References 13 publications

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“…The endoscope is inserted through trochar from the abdominal wall to the gastrostomy opening and then to the biliary tract. This technique was successful in 9 out of 10 patients included in the study by Lopes et al These impressive results were confirmed by Bertin et al, in which successful biliary cannulation was achieved in 94% of 21 RYGBP patients who underwent laparoscopic assisted ERCP [50]. In conclusion, bariatric surgeries are increasing due to the obesity epidemic.…”

Section: Endoscopy In the Treatment Of Bariatric Surgery Complicationsmentioning

confidence: 76%

Role of Endoscopy in Laparoscopic Procedures

Othman¹,

Patel²,

Woodward³

2011

Updated Topics in Minimally Invasive Abdominal Surgery

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Section: Endoscopy In the Treatment Of Bariatric Surgery Complicationsmentioning

confidence: 76%

Role of Endoscopy in Laparoscopic Procedures

Othman¹,

Patel²,

Woodward³

2011

Updated Topics in Minimally Invasive Abdominal Surgery

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“…Case series described in the literature point to success rates up to 100.0%, with complication rates similar to the traditional procedure [10,[43][44][45][46][47], demonstrating that it is technically superior to those using long frontal vision devices.…”

Section: Discussionmentioning

confidence: 99%

“…2017;7(4):58-63 the surgical team throughout the procedure are important factors that limit the diffusion of the use of this technique [10,[43][44][45][46][47].…”

Section: Discussionmentioning

confidence: 99%

“…When compared to procedures that somehow combine the use of duodenoscope and transgastric access to the bile duct [10,[38][39][40][41][42][43][44][45][46][47] the method of the present study presents important advantages. Because it is performed in a single surgical time, without having to wait for the gastrostomy maturation, different from other reports of gastrostomy use [35][36][37][39][40][41][42], its use is adequate in the emergency scenarios, making its application more comprehensive.…”

Section: Discussionmentioning

confidence: 99%

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Approach of the Bile Duct by Gastrostomy in Patients With Bypass in Roux-en-Y Proved to Be Safe and Effective

et al. 2017

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Background: The prevalence and increase of obesity in the world are that 2.3 billion adults were overweight and 700 million adults were obese in 2015. In the context of the morbid obesity pandemic, bariatric surgery was presented as a gold standard treatment. It is known that the prevalence of cholelithiasis is 3 to 4 times higher in morbidly obese patients when compared to the general population. Literature reports that the first attempts to approach the biliary tract in patients with gastric bypass in Roux-en-Y, were performed transorally and had resulted in low success rates. The aim of this study was to analyze the results of the use of the endoscopic transgastrostomy technique for the treatment of biliary tract diseases in patients submitted to Yde-Roux bypass.

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“…While cost is a significant disadvantage, surgery would still be the first choice in community hospitals where there are limited facilities for balloon endoscopy or where there is time and skill constraints. Furthermore, sometimes the previous operative report of the RYGB surgery might not detail the technique used, post-operative complication or the anatomy and length of the roux as well as pancreatico-biliary limb [7][8][9][10]. The disadvantages of surgery-assisted ERCP are that it involves surgery and that it may take time for the surgeon to identify the gastric remnant due to the altered anatomy from previous surgery in these patients [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopy Assisted ERCP

Alhashimalsayed¹,

Hayaf²,

Joy³

2017

GHOA

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Laparoscopy Assisted ERCPSubmit Manuscript | http://medcraveonline.com obesity trend suggests that by 2025, the prevalence of obesity worldwide will reach 18% for males and surpass 21% in women [1]. The trend of obesity in the Middle East is particularly pronounced and exceeds 50% among women in many countries in this region. Bariatric surgery has been found to be effective for weight loss and reduce the consequences of obesity.However, long term health consequences of bariatric surgery are not fully clear. The weight loss that accompanies bariatric Roux-en-Y gastric bypass (R-e-YGB) is a risk factor for cholelithiasis which in turn increases the risk of choledocholithiasis and gall stone pancreatitis. Around 7-8% of post R-e-YGB patients become symptomatic with gall stone disease that require cholecystectomy. Therefore, due to this relative low prevalence rate of gall stone disease, recommending prophylactic cholecystectomy in patients undergoing R-e-YGB might be an overkill and is not generally advocated [1]. While performing cholecystectomy in R-e-YGB patients is relatively straightforward, performing Endoscopic Retrograde Cholangiopancreatography (ERCP) with conventional scope is technically challenging in these cases.We report a case of laparoscopically-assisted ERCP with review of the literature. Case ReportA 30-year-old woman status post R-e-YGB surgery for obesity 4 years ago. She was admitted with acute gall stone pancreatitis. Biliary imaging confirmed choledocholithiasis and cholelithiasis. ERCP was attempted using a conventional colonoscope under conscious sedation using midazolam and fentanyl. However, despite entering the pancreatico-biliary limb (roux limb) of the intestine and visualizing bile, this was not successful in identifying the ampulla. This procedure took around 2 hours and had to be abandoned.She later underwent Laparoscopy with assisted ERCP and subsequent cholecystectomy. The patient had standard laparoscopy for access into the peritoneal cavity. After identification of the gastric remnant, the therapeutic duodenoscope was introduced into the abdominal cavity via left upper quadrant incision and inserted into the remnant stomach through the gastrostomy. It was passed into the duodenum with access to the ampulla without difficulties. The common bile duct was cannulated using guide wire. Cholangiogram reveled stones in the common bile duct which were extracted after sphincterotomy with balloon. It was an uncomplicated procedure. The total operative time was 100 minutes. The patient was discharged the next day with good recovery. The patient was reviewed a month later and was asymptomatic.There were no real difficulties in manipulating the duodenoscope. There were no ERCP related complications. The postoperative care was similar to conventional cholecystectomy or other laparoscopy procedures. There was close collaboration between the surgeon and the endoscopist to harmonize their timetable and to ensure optimal positioning of the endoscopic and radiological equipment during the procedur...

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Laparoscopic transgastric endoscopic retrograde cholangiopancreatography (ERCP) after gastric bypass: case series and a description of technique

Cited by 68 publications

References 13 publications

Role of Endoscopy in Laparoscopic Procedures

Role of Endoscopy in Laparoscopic Procedures

Approach of the Bile Duct by Gastrostomy in Patients With Bypass in Roux-en-Y Proved to Be Safe and Effective

Laparoscopy Assisted ERCP

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