Related Experiment Video
Updated: Apr 7, 2026
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Case Series: Endoscopic ultrasound-directed transgastric ERCP in liver transplant recipients with Roux-en-Y gastric
Peyton Crest1, Julius S Navarro2, Fawzy Barry3
1Division of Transplant, Department of Surgery, University of California, San Francisco, CA, United States.
Introduction:
Among liver transplant recipients, Roux-en-Y gastric bypass (RYGB) may lead to postoperative malnutrition and nutrient deficiencies. Procedures such as the endoscopic ultrasound-directed transgastric ERCP (EDGE) can result in advantageous weight gain for liver transplant recipients with prior RYGB who do not respond to enteral or parenteral nutritional interventions.
Methods:
We present three patients who underwent EDGE for post-transplant malnutrition and weight loss.
Results:
EDGE resulted in weight gain across all patients. Liver transplant recipients with a history of RYGB may be at significant nutritional risk following transplant due to fat malabsorption, underestimation of resting energy expenditure, and appetite suppression mediated by neurohormonal signals.
Conclusion:
When traditional nutritional interventions are unsuccessful, the EDGE procedure may be an effective alternative to promote post-transplant weight gain in this unique population.
