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Review
. 2022 Jul;32(3):563-582.
doi: 10.1016/j.giec.2022.02.001. Epub 2022 May 11.

Biliary Endoscopy in Altered Anatomy

Linda Y Zhang  1 , Shayan Irani  2 , Mouen A Khashab  3
Affiliations
Review

Biliary Endoscopy in Altered Anatomy

Linda Y Zhang et al. Gastrointest Endosc Clin N Am. 2022 Jul.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is the standard treatment of biliary disease with high success rates of greater than 90% in patients with standard anatomy. However, alterations in upper gastrointestinal anatomy can significantly complicate endoscopic biliary intervention. The past decade has seen significant advances in the endoscopic management of patients with altered anatomy. This review article will provide tips and tricks for successful biliary access in the most common surgical alterations with a focus on the management of biliary diseases following Roux-en-Y (RY) reconstructions.

Keywords: Altered anatomy ERCP; EUS-Directed trans-gastric ERCP; Enteroscopy-assisted ERCP; Gastrectomy; Laparoscopy-assisted ERCP; Roux-en-y gastric bypass; Whipple surgery.

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