Intraoperative transgastric ERCP after a Roux-en-Y gastric bypass

Abstract

Roux-en-Y gastric bypass (RYGB) is among the favorite surgical approaches to treating morbidly obese patients, but leads to an increased incidence of choledocolithiasis. Per-oral endoscopic retrograde cholangiopancreatography (ERCP) represents a major challenge in this situation [1] [2]. ERCP through a surgically placed gastrostomy has been proposed as an alternative route for endoscopic access [3] [4] [5]. We report a case of endoscopically treated choledocolithiasis via a transgastric approach during laparoscopic cholecystectomy in a RYGB patient.