title: Laparoscopic transgastric access to the biliary tree after Roux-en-Y gastric bypass.
abstract: Gallstone disease, common after Roux-en-Y gastric bypass (RYGBP), may be complicated by biliary duct obstruction and gallstone pancreatitis. Although endoscopic retrograde cholangiopancreatography plays an important role in management of biliary duct obstruction, the altered anatomy of patients who have had a RYGBP makes this procedure technically difficult. With the increased number of patients undergoing RYGBP for morbid obesity, bariatric surgeons may benefit from an alternative laparoscopic technique for accessing the biliary tree. We describe a laparoscopic technique of accessing the biliary tree through the bypassed stomach.
authors.affiliation: Department of Surgery, University of California, Irvine Medical Center, Orange, CA, USA. ninhn@uci.edu
authors.forename: Ninh T
authors.initials: NT
authors.lastname: Nguyen
authors.forename: Marcelo W
authors.initials: MW
authors.lastname: Hinojosa
authors.forename: Johnathan
authors.initials: J
authors.lastname: Slone
authors.forename: John
authors.initials: J
authors.lastname: Lee
authors.forename: Vishal
authors.initials: V
authors.lastname: Khiatani
authors.forename: Samuel E
authors.initials: SE
authors.lastname: Wilson
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D042883:Choledocholithiasis / Q000175:diagnosis* / Q000601:surgery; D002768:Choledochostomy / Q000379:methods; D003135:Common Bile Duct / Q000473:pathology; D019299:Decompression, Surgical; D004108:Dilatation, Pathologic; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects; D018530:Gastric Stump; D006500:Hepatic Duct, Common / Q000473:pathology; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009767:Obesity, Morbid / Q000601:surgery; D011184:Postoperative Period; D016717:Sphincterotomy, Endoscopic / Q000379:methods*