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Endoscopic Procedures V: ERCP

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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Related Experiment Video

Updated: Jun 29, 2025

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

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Technical Considerations in Laparoscopic-Assisted Endoscopic Retrograde Cholangiography.

Eric H Mace¹, Patrick S Yachimski², Marcus C Tan³

¹Department of General Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

The American Surgeon

|April 8, 2024

Summary

Laparoscopic-assisted endoscopic retrograde cholangiography (ERCP) provides a safe method for pancreaticobiliary interventions after Roux-en-Y gastric bypass. This technique enables standard ERCP in patients where the oropharyngeal approach is not feasible.

Keywords:

Roux-en-Y endoscopic retrograde cholangiography endoscopy gastric bypass laparoscopic-assisted endoscopic retrograde cholangiography

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Area of Science:

Gastroenterology
Surgical Endoscopy
Bariatric Surgery

Background:

Endoscopic retrograde cholangiography (ERCP) is crucial for pancreaticobiliary diagnostics and therapeutics.
Roux-en-Y gastric bypass (RYGB) surgery alters anatomy, prohibiting standard oropharyngeal ERCP access.
Alternative ERCP methods are needed for post-RYGB patients.

Purpose of the Study:

To describe the technical aspects of performing laparoscopic-assisted ERCP.
To evaluate the safety and efficacy of this approach in post-RYGB patients.
To provide a feasible ERCP option for the pancreaticobiliary system in this population.

Main Methods:

Laparoscopic access to the gastric remnant was utilized.
A standard side-viewing duodenoscope was employed for ERCP.
Standard and advanced endoscopic maneuvers were performed.
Technical aspects of the procedure were documented.

Main Results:

Laparoscopic-assisted ERCP was successfully performed.
The approach allowed for safe and effective diagnostic and therapeutic interventions.
Standard ERCP techniques were adaptable to the altered anatomy.

Conclusions:

Laparoscopic-assisted ERCP is a viable and safe alternative for post-RYGB patients.
This technique facilitates essential pancreaticobiliary interventions.
It expands endoscopic capabilities for a challenging patient group.