Obesity Surgery

, Volume 20, Issue 6, pp 791–795 | Cite as

Temporary Restoration of Digestive Continuity After Laparoscopic Gastric Bypass to Allow Endoscopic Sphincterotomy and Retrograde Exploration of the Biliary Tract

  • Arnaud Saget
  • Enrico Facchiano
  • Pierre-Olivier Bosset
  • Benjamin Castel
  • Philippe Ruszniewski
  • Simon MsikaEmail author
Case Report


The prevalence of morbid obesity is rapidly increasing worldwide. As surgery has been recognized to be the only effective treatment for morbid obesity, the number of bariatric procedure realized each year has dramatically increased. Among all the surgical options, gastric bypass in considered as the gold standard. A possible drawback of this operation is the difficult access to the excluded proximal intestinal tract and, consequently, to the biliary tract. As gallstone formation may be frequent after a rapid weight loss induced by surgery, surgeons could be frequently asked to face the need of exploration of the biliary tree after anatomical changes induced by this kind of surgery. Many technical solutions, mainly based on a combined laparoscopic and endoscopic approach, have been proposed by several authors to face this problem. We herein describe an original technique to allow endoscopic exploration of biliary tract after a laparoscopic gastric bypass based on temporary restoration of physiological digestive continuity followed by re-establishment of the Roux-en-Y loop.


Laparoscopy Obesity surgery Sphincterotomy Gastric bypass Endoscopic retrograde cholangiopancreatography 


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Copyright information

© Springer Science + Business Media, LLC 2010

Authors and Affiliations

  • Arnaud Saget
    • 1
  • Enrico Facchiano
    • 1
  • Pierre-Olivier Bosset
    • 1
  • Benjamin Castel
    • 1
  • Philippe Ruszniewski
    • 2
  • Simon Msika
    • 1
    Email author
  1. 1.Department of Surgery, Louis Mourier Hospital, Assistance Publique–Hopitaux de ParisUniversity Denis Diderot Paris VIIParisFrance
  2. 2.Department of Gastroenterology, Beaujon Hospital, Assistance Publique–Hopitaux de ParisUniversity Denis Diderot Paris VIIParisFrance

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