Laparoscopy-Assisted Transgastric ERCP

Completed

• Conditions: Biliary Obstruction

• Registration Number: NCT03925766
• Lead Sponsor: Tecnologico de Monterrey

Brief Summary

We describe a case of a 57-year-old patient with altered RYGB anatomy, who underwent a laparoscopic cholecystectomy with a intra-operative cholangiogram showing a stone on the common bile duct. A laparoscopic assisted trans-gastric ERCP was successfully performed. The presentation of the case is presented as well a review of the literature.

Detailed Description

The exclusion of the stomach after Roux-en-Y-Gastric bypass (RYGB) makes access to the biliary tree very challenging for the surgeon or the endoscopist. There are different techniques described to overcome this downside, being laparoscopic assisted trans-gastric endoscopic retrograde cholangiopancreatography (ERCP) approach an outstanding method to access the remnant stomach for reaching the duodenal papilla, with a high rate of success reported. We describe a case of a 57-year-old patient with altered RYGB anatomy, who underwent a laparoscopic cholecystectomy with a intra-operative cholangiogram showing a stone on the common bile duct. A laparoscopic assisted trans-gastric ERCP was successfully performed, introducing the duodenoscope through a gastrostomy without the need of an intra-gastric trocar. The patient evolved favorably and was discharged on his second postoperative day without complications.

Study Timeline

• Study Start: 2019-03-01
• Status Verified: 2019-04
• Primary Completion: 2019-04-01
• Study Completion: 2019-04-20
• Study First Submitted: 2019-04-22
• Study First Submitted QC: 2019-04-22
• Last Update Submitted: 2019-04-22
• Study First Posted: 2019-04-24
• Last Update Posted: 2019-04-24

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Male
• Target Recruitment: 1

Inclusion Criteria

• Patient with altered Roux en Y Gastric Bypass anatomy

Exclusion Criteria

• Patients without Roux en Y Gastric Bypass anatomy

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Proof the efficacy of laparoscopic assisted transgastric endoscopic retrograde cholangiopancreatography	April 2019	This technique is a feasible and achievable procedure with low rate of complications for treating patients with altered RYGB anatomy that present biliary tract disorders, allowing an endoscopic treatment and cholecystectomy to be performed in a single setting.

Trial Locations

Locations (1)

Escuela Nacional de Medicina, Tecnologico de Monterrey; 🇲🇽 Monterrey, Nuevo Leon, Mexico