Carvajal-López A, Ricardo-Ramírez AM, Franco-Cardona S, Aristizábal-Bedoya M

Language: Spanish
References: 9
Page: 91-95
PDF size: 1532.76 Kb.

ABSTRACT

Introduction: endoscopic retrograde cholangiopancreatography (ERCP) is the standard treatment for choledocholithiasis; however, in patients with Roux-en-Y gastric bypass, conventional endoscopic access is limited due to altered gastrointestinal anatomy. Laparoscopic transgastric ERCP (LT-ERCP) has emerged as a minimally invasive alternative. Objective: to describe the cases of two patients with a history of gastric bypass and choledocholithiasis who underwent transgastric ERCP and laparoscopic cholecystectomy. Clinical cases: we report two cases of post-bypass patients with choledocholithiasis successfully treated with LT-ERCP and laparoscopic cholecystectomy. A 15 mm transgastric trocar was used to introduce the duodenoscope under laparoscopic guidance. One patient experienced an intraoperative duodenal enterotomy, which was promptly repaired without clinical consequences. No major postoperative complications were observed. LT-ERCP is a safe and effective approach, particularly in centers without access to advanced endoscopic techniques such as double-balloon enteroscopy, and can be performed with resources commonly available in advanced laparoscopic surgery units. Results: both clinical cases were resolved successfully. Conclusions: laparoscopic transgastric ERCP proved useful and safe in these two cases.

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