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. 2016 Nov;26(11):2809-2813.
doi: 10.1007/s11695-016-2360-4.

Laparoscopy-Assisted Trans-Gastric Rendez-vous for the Treatment of Common Bile Duct Stones in Patients with Prior Roux-en-Y Gastric Bypass

Ricardo Mejía  1 , Pablo Achurra  1 , Mauricio Gabrielli  1 , Eduardo Briceño  1 , Rolando Rebolledo  1 , Alberto Torres  1 , Allan Sharp  1 , Fernando Pimentel  1 , Fernando Crovari  2
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Laparoscopy-Assisted Trans-Gastric Rendez-vous for the Treatment of Common Bile Duct Stones in Patients with Prior Roux-en-Y Gastric Bypass

Ricardo Mejía et al. Obes Surg. 2016 Nov.

Abstract

Background: Common bile duct (CBD) stones in a Roux-en-Y gastric bypass (RYGB) represent a major challenge for ERCP due to long-limb anatomy. Trans-gastric approach has been proposed but entails high ERCP-related risks. Laparoscopy assisted trans-gastric rendez-vous (LATG-RV) is a one-step procedure that may lower the risks of these patients.

Methods: We describe our initial experience in four patients with past history of RYGB and CBD stones.

Results: All patients underwent LATG-RV and had successful CBD stone clearance. Postoperative course was uneventful with normal amylase levels. Average procedure time was 105 min and postoperative stay 2 days.

Conclusion: LATG-RV is a safe and effective procedure for the clearance of CBD stones in RYGB patients. It may have fewer complications and shorter operative time than regular trans-gastric ERCP.

Keywords: Choledocolithiasis; Common bile duct stones; Gastric bypass; Rendez-vous; Trans-gastric ERCP.

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