title: Endoscopic retrograde cholangiopancreatography in patients with Roux-en-Y anatomy.
abstract: BACKGROUND
  Roux-en-Y gastric bypass is increasingly performed in the United States. In addition, liver transplantation and other complex hepatobiliary surgeries are increasingly performed with creation of a Roux-en-Y hepaticojejunostomy. Consequently, endoscopists more frequently need to carry out endoscopic procedures in patients with Roux-en-Y anatomy.
  
  
  METHODS
  The present article discusses the techniques and instruments available to therapeutic endoscopists who are faced with the challenge of performing endoscopic retrograde cholangiopancreatography (ERCP) in patients with long- or short-limb Roux-en-Y anatomy.
  
  
  CONCLUSIONS
  Endoscopists can successfully perform ERCP in patients with Roux-en-Y anatomy by making use of appropriate techniques and instruments.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street S.W, Charlton 8A, Rochester, MN 55905, USA.
authors.forename: Tercio L
authors.initials: TL
authors.lastname: Lopes
authors.forename: Todd H
authors.initials: TH
authors.lastname: Baron
mesh_terms: D000713:Anastomosis, Roux-en-Y; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D006801:Humans; D009767:Obesity, Morbid / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods*