London Live Endoscopy Top Tips: Biliary access in Roux-en-Y gastric bypass

Dr George Webster discusses the 4 approaches to biliary access in patients following a bariatric RYGB

Hepatobiliary endoscopists are facing an increasing cohort of patients who have undergone a bariatric Roux-en-Y gastric bypass (RYGB) and subsequently present with choledocholithiasis. Biliary calculi are more common in overweight patients and those who have undergone RYGB surgery. Due to the long afferent limb involved in the surgery conventional ERCP access is not possible. Here, Dr George Webster talks us through the four alternative approaches.



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