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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
LOPEZ-URIBE, Federico et al. Laparoscopic-assisted endoscopic cholangiopancreatography for the treatment of choledocholithiasis in patients with Roux-en-Y. rev. colomb. cir. [online]. 2023, vol.38, n.4, pp.656-665. Epub June 13, 2023. ISSN 2011-7582. https://doi.org/10.30944/20117582.2276.
Introduction.
Patients with a history of gastric bypass who present with choledocholithiasis cannot be treated with the conventional technique of endoscopic retrograde cholangiopancreatography. In these cases, the open or laparoscopic-assisted transgastric approach becomes an excellent alternative to open bile duct gastric exploration.
Methods.
A retrospective review of patients with choledocholithiasis and a history of subtotal gastrectomy or gastric bypass with Roux-en-Y, who underwent laparo-assisted transgastric endoscopic cholangiopancreatography, was conducted between January 2019 and December 2021 at Clínica CES de Medellín, Colombia.
Results.
Seven patients were found, all with a history of gastric bypass secondary to obesity. The rate of bile duct identification and cannulation, and stone removal was 100% using the laparo-assisted transgastric approach.
Conclusion.
According to several systematic reviews, this technique is relatively easy to implement and safe, presenting a rate of complications less than 5%. A variant to this technique is proposed.
Keywords : choledocholithiasis; endoscopic retrograde cholangiopancreatography; obesity; gastric bypass; laparoscopy.