Post written by Steven R. Siegal, MD, from AdventHealth, Orlando, Florida, USA. We demonstrate a case of a Roux-en-Y anastomotic dehiscence that was rescued via total endoscopic means over various sessions. It is important to know the available endoscopic tools and how they can be used in a complementary fashion to essentially perform surgical procedures. It …
Continue reading Endoscopic rescue of anastomotic dehiscence after urgent gastric bypass revision
Post written by Rishi Pawa, MD, FACG, from the Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. A 56-year-old man with a medical history of metastatic duodenal adenocarcinoma, status postpartial gastrectomy, and duodenectomy with Roux-en-Y gastrojejunostomy (GJ) presented with gastric outlet obstruction. Endoscopy revealed an ulcerated stricture at the gastrojejunal anastomosis, with biopsies confirming recurrent …
Post written by Chaitanya Allamneni, MD, from the Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. A young woman with a medical history of primary sclerosing cholangitis/autoimmune hepatitis overlap syndrome diagnosed at age 2, complicated by decompensated cirrhosis, underwent orthotopic liver transplantation (OLT). During OLT she underwent a standard Roux-en-Y hepaticojejunostomy. Twenty-four …
Post written by Yohei Koyama, MD, from the Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. Balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) has improved the outcomes of ERCP in patients with surgically altered anatomy. However, BE-ERCP requires high technical expertise, and biliary cannulation is often difficult. An 83-year-old man previously underwent total gastrectomy …
Continue reading “Two-devices-in-one-channel method” in a Roux-en-Y patient
Nikhil A. Kumta, MD from the Division of Gastroenterology and Hepatology at Weill Cornell Medical College in New York, New York, USA presents this video case, "Bypassing the bypass: EUS-directed transgastric ERCP for Roux-en-Y anatomy." Patients with altered anatomy from a Roux-en-Y gastric bypass pose distinct challenges to performing endoscopic retrograde cholangiopancreatography (ERCP). In this …
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