Bypassing the bypass: EUS-directed transgastric ERCP for Roux-en-Y anatomy.

@article{Kedia2015BypassingTB,
  title={Bypassing the bypass: EUS-directed transgastric ERCP for Roux-en-Y anatomy.},
  author={Prashant S. Kedia and Nikhil A. Kumta and Reem Z. Sharaiha and Michel Kahaleh},
  journal={Gastrointestinal endoscopy},
  year={2015},
  volume={81 1},
  pages={223-4}
}
Patients with Roux-en-Y gastric bypass (RYGB) pose distinct challenges to performing ERCP. We propose an alternative endoscopic approach that uses EUS to gain PEG access to the excluded stomach in patients with RYGB anatomy. This video (Fig. 1; Video 1, available online at www.giejournal.org) describes an EUS-directed transgastric ERCP (EDGE) in 6 patients with RYGB anatomy (5 women, 1 man, average age 50.7 years) with biliary disease done by 2 expert biliary endoscopists. The EDGE technique is… CONTINUE READING

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