VideoGIEBypassing the bypass: EUS-directed transgastric ERCP for Roux-en-Y anatomy
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Disclosure
M. Kahaleh is a consultant for Boston Scientific and Xlumina and has done research for Gore, MI Tech, and Pinnacle. He has done research and consulting for Maunakea. No other financial relationships relevant to this article were disclosed.
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Laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography: Preliminary experience and technique description
2019, Journal of Visceral SurgeryCitation Excerpt :Accessing the biliary tree in patients with a surgically altered anatomy or upper GI stenosis has become an important issue nowadays. This has been widely demonstrated taking into account all different types of techniques described to overcome this problem [5–8,10–12,15,16]. Surgical common bile duct exploration was the gold-standard procedure for treatment of bile duct stones a few decades ago.
First case report of bile leak from the duct of Luschka in a patient with mini-gastric bypass: The challenge of management
2018, Annals of Medicine and SurgeryCitation Excerpt :Choi et al. showed that ERCP via gastrostomy is hindered by the gastrostomy maturation delay and a higher morbidity [15]. Third, the latest approach consisted of endoscopic ultrasound-directed transgastric ERCP, where access to the excluded stomach is done through the creation of a gastro-gastric fistula tract, covered with a metallic stent that allowed the antegrade passage of a duodenoscope [16]. However, no cases after MGB procedure were reported.
Multicenter evaluation of the clinical utility of laparoscopy-assisted ERCP in patients with Roux-en-Y gastric bypass
2018, Gastrointestinal EndoscopyCitation Excerpt :It is noteworthy that EUS-guided transgastric ERCP is currently an evolving and promising approach that involves deploying lumen-apposing metal stents through the newly formed gastrogastric fistula.18 The intended ERCP could then be performed by passing the endoscope into the remnant stomach through the lumen-apposing metal stent.18-20 This approach can potentially offer great advantages, including the lack of need for a surgical team, minimal invasiveness, and the higher success rate and shorter operative time compared with enteroscopy-assisted ERCP.
EUS-directed transgastric ERCP for Roux-en-Y gastric bypass anatomy: A minimally invasive approach
2015, Gastrointestinal EndoscopyCitation Excerpt :Biliary access in Roux-en-Y gastric bypass patients can be challenging. Multiple different techniques, including enteroscopy-assisted ERCP, laparoscopy-assisted ERCP, and external EDGE, have been described.2,4,5 However, the optimal procedure is one that can be performed in 1 stage by a single team in a minimally invasive fashion.
Use of lumen apposing metal stents in patients with altered gastrointestinal anatomy
2023, Current Opinion in Gastroenterology