*EMBARGOED All research presented at the ACG Annual Scientific Meeting is strictly embargoed until Monday, October 17, 2016 at 8:00 am EDT.
Oral 59 Multicenter Evaluation of the Clinical Utility of Laparoscopy-Assisted ERCP in Patients with Roux-en-Y Gastric Bypass (RYGB)
Author Insight from Ali M. Abbas, MD, MPH, University of South Florida
What’s new here and important for clinicians?
Our results represent the first large multicenter evaluation of a newly described Laparoscopy-Assisted Endoscopic Retrograde Cholangiopancreatography (LA-ERCP) procedure that is indicated in patients who had Roux-en-Y Gastric Bypass (RYGB) for pancreaticobiliary endoscopic interventions. RYGB creates a bypass to most of the stomach, and all of the duodenum and proximal part of the jejunum. This makes the access to the biliary or pancreatic trees exceedingly difficult by the conventional per oral ERCP procedure. On the other hand, obese patients are at increased risk of choledocholithiasis and gallstone pancreatitis especially in the setting of rapid weight loss after bariatric surgery. Providing a reliable access to the biliary or pancreatic trees is crucial in these patients.
What do patients need to know?
Patients who had RYGB procedure are at higher risk of developing common bile duct stones and acute gallstone pancreatitis. LA-ERCP provides a reliable success rate in these patient higher than 95% in treating these conditions. Whereas the conventional approach has about 35% and the balloon-assisted approach has about 70% success rate.
See Figure 1: a map showing the participating centers in this study.
Ali M. Abbas, MD, MPH, University of South Florida
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