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Single-Session Endoscopic Ultrasound-Directed Transgastric ERCP (“EDGE”) in a Bariatric Patient with Pancreatic Mass and Biliary Obstruction

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Abstract

This video case report presents a patient with an invasive pancreatic mass and a history of Roux-en-Y gastric bypass surgery who underwent single-session endoscopic ultrasound-directed transgastric ERCP for tissue sampling and biliary stenting with subsequent maintenance of the newly established gastrogastrostomy. The demonstrated technique enables spectrum of endoscopic interventions in gastric bypass patients by facilitating a direct endoscopic passage through the reconnected stomach. Importantly, the method carries a risk of weight regain by essentially reversing the bypass. However, this can be an actual desire in selected cases, e.g., oncologic patients, making it a favorable choice over other alternatives.

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Authors and Affiliations

  1. Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, 420 Delaware Street SE, MMC 36, Minneapolis, MN, 55455, USA

    Petr Vanek, Shawn Mallery, Martin L. Freeman & Guru Trikudanathan

  2. 2nd Department of Internal Medicine, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic

    Petr Vanek

Authors
  1. Petr Vanek
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  2. Shawn Mallery
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  3. Martin L. Freeman
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  4. Guru Trikudanathan
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Contributions

P Vanek wrote the manuscript and edited the video; S Mallery and ML Freeman critically revised the manuscript; and G Trikudanathan performed the procedure, revised, and edited the manuscript and is the article guarantor.

Corresponding author

Correspondence to Guru Trikudanathan.

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All authors have no conflicts of interest to declare. Informed consent was obtained for this case report. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Vanek, P., Mallery, S., Freeman, M.L. et al. Single-Session Endoscopic Ultrasound-Directed Transgastric ERCP (“EDGE”) in a Bariatric Patient with Pancreatic Mass and Biliary Obstruction. OBES SURG 30, 4681–4683 (2020). https://doi.org/10.1007/s11695-020-04839-z

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  • DOI: https://doi.org/10.1007/s11695-020-04839-z

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