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Accessing the biliary ducts for performing endoscopic retrograde cholangiopancreatography (ERCP) and relevant interventional procedures after gastric bypass surgery is technically difficult and frequently unsuccessful due to anatomical alterations. To overcome such technical challenges, laparoscopic-assisted ERCP (LA-ERCP) is used to approach the biliary ducts via nonperoral reliable access for performing different endoscopic biliary interventions. In this case series, we report a total of three patients with different anatomical alterations who underwent LA-ERCP.

innovations in surgery and interventional medicine

Laparoscopic-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients With Prior Gastric Bypass Surgery: A Case Series of Technical Challenges