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Updated: Jul 16, 2025
Roux-en-Y Gastric Bypass Operation in Rats
Published on: June 11, 2012
Endoscopic retrograde cholangiopancreatography (ERCP) approach for patients with Roux-en-Y gastric bypass: a
Rabih Ghazi1, Farah Abdul Razzak2, Anthony Kerbage2
1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota; Division of Internal Medicine, Cooper University Hospital, Camden, New Jersey.
Background:
Endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in patients with Roux-en-Y gastric bypass (RYGB) due to altered anatomy.
Objective:
To compare the procedural and clinical outcomes of 4 different ERCP techniques in RYGB patients.
Setting:
Academic tertiary referral center in the United States.
Methods:
A retrospective cohort study including patients with RYGB anatomy who underwent an ERCP between January 2015 and September 2020. We compared procedural success and adverse events (AEs) rates of balloon-assisted enteroscopy (BAE), gastrostomy-assisted ERCP (GAE), endoscopic ultrasound (EUS)-directed transgastric ERCP (EDGE), and rendezvous guidewire-assisted ERCP (RGA).
Results:
Seventy-eight RYGB patients underwent a total of 132 ERCPs. The mean age was 60 ± 11.8 years, with female predominance (85.7%). The ERCP procedures performed were BAE (n = 64; 48.5%), GAE (n = 18; 13.7%), EDGE (n = 25; 18.9%), and RGA (n = 25; 18.9%), with overall procedure success rates of 64.1%, 100%, 89.5%, and 91.7%, respectively. All approaches were superior to BAE (GAE versus BAE, P = .003; EDGE versus BAE, P = .034; RGA versus BAE, P = .011). The overall AE rates were 10.9%, 11.1%, 15.8 %, and 25.0%, respectively. There was no statistical difference in AEs. There were also no differences in bleeding, post-ERCP pancreatitis, and perforation rates between the 4 approaches.
Conclusion:
Procedure success was similar between GAE, RGA, and EDGE, but superior to BAE. AE rates were similar between approaches.
