Endoscopic transgastric retrograde cholangiopancreatography assisted by laparoscopy in a patient with gastric bypass

Authors

  • Carmelo Blasco Departamento de Gastroenterología y Endoscopía Digestiva, Universidad Nacional de Asunción, Hospital de Clínicas, San Lorenzo, Paraguay. https://orcid.org/0009-0009-4072-4576
  • Carolina Miranda Departamento de Gastroenterología y Endoscopía Digestiva, Universidad Nacional de Asunción, Hospital de Clínicas, San Lorenzo, Paraguay. https://orcid.org/0009-0008-2213-4970
  • Sergio Morinigo Departamento de Gastroenterología y Endoscopía Digestiva, Universidad Nacional de Asunción, Hospital de Clínicas, San Lorenzo, Paraguay. https://orcid.org/0009-0000-2293-5198
  • Maisa Vallejos Departamento de Gastroenterología y Endoscopía Digestiva, Universidad Nacional de Asunción, Hospital de Clínicas, San Lorenzo, Paraguay. https://orcid.org/0009-0001-5052-3542

DOI:

https://doi.org/10.47892/rgp.2025.451.1816

Keywords:

Gastric Bypass, Cholangiopancreatography, Endoscopic Retrograde, Laparoscopy

Abstract

Obesity is a global public health problem. The development of new surgical techniques and endoscopic procedures, along with the continuous advancement of instruments and equipment in the field of gastrointestinal endoscopy, allows for the management of increasingly complex cases, including complications that may arise in patients undergoing therapeutic procedures related to obesity. The approach to the biliary tract in patients previously subjected to gastrojejunal bypass for the treatment of morbid obesity is complex due to the alterations in the anatomy of the upper gastrointestinal tract, posing a challenge for the endoscopist. In these cases, a valid alternative for managing biliary pathology is transgastric endoscopic retrograde cholangiopancreatography (LA-ERCP) assisted by laparoscopy. Below, we present a case in which LA-ERCP was used to manage biliary stones in a patient with a history of gastric bypass.

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References

Organización Mundial de la Salud. Obesidad y sobrepeso [Internet]. Ginebra: OMS; 2024 [citado 18 de enero de 2025]. Disponible en: https://www.who.int/es/news-room/factsheets/detail/obesity-and-overweight

Brown WA, Liem R, Al-Sabah S, Anvari M, Boza C, Cohen RV, et al. Metabolic Bariatric Surgery Across the IFSO Chapters: Key Insights on the Baseline Patient Demographics, Procedure Types, and Mortality from the Eighth IFSO Global Registry Report. Obes Surg. 2024;34(5):1764-77. doi: 10.1007/s11695-024-07196-3.

Koggel LM, Wahab PJ, Robijn RJ, Aufenacker TJ, Witteman BPL, Groenen MJM, et al. Efficacy and Safety of 100 Laparoscopy-Assisted Transgastric Endoscopic Retrograde Cholangiopancreatography Procedures in Patients with Roux-en-Y Gastric Bypass. Obes Surg. 2021;31(3):987-93. doi: 10.1007/s11695-020-04946-x.

Baron TH, Wong Kee Song LM. Percutaneous assisted transprosthetic endoscopic therapy (PATENT): expanding gut access to infinity and beyond! (with video). Gastrointest Endosc. 2012;76(3):641-4. doi: 10.1016/j.gie.2012.05.027.

Petersen BD, Nørregaard C, Krøijer R, Floyd A, Ploug M. Laparoscopic-Assisted ERCP in Gastric Bypass Patients—No Stones Left Unturned: A Single Center Retrospective Cohort Study. Obes Surg. 2024;34(8):2999-3004. doi: 10.1007/s11695- 024-07268-4.

Kedia P, Sharaiha RZ, Kumta NA, Kahaleh M. Internal EUS-Directed Transgastric ERCP (EDGE): Game Over. Gastroenterology. 2014;147(3):566-8. doi: 10.1053/j. gastro.2014.05.045.

Kröll D, Müller AC, Nett PC, Wiest R, Maubach J, Stirnimann G, et al. Tailored access to the hepatobiliary system in postbariatric patients: a tertiary care bariatric center experience. Surg Endosc. 2020;34(12):5469-76. doi: 10.1007/s00464-019- 07343-3.

Kadkhodayan K, Irani S. EUS-guided hepaticogastrostomy: practical tips and tricks. VideoGIE. 2024;9(9):417-24. doi: 10.1016/j.vgie.2024.05.015.

Published

03/31/2025

How to Cite

1.
Blasco C, Miranda C, Morinigo S, Vallejos M. Endoscopic transgastric retrograde cholangiopancreatography assisted by laparoscopy in a patient with gastric bypass. Rev Gastroenterol Peru [nternet]. 2025 Mar. 31 [cited 2025 Dec. 7];45(1):75-8. vailable from: https://revistagastroperu.com/index.php/rgp/article/view/1816

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REPORTES DE CASOS

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