ASGE Annual GI Advanced Practice Provider Course (Virtual) - Onboarding (Day One) | March 2024-Approach to Patients with RYGB Requiring ERCP

Pdf Summary

The document discusses the approach to patients with Roux-en-Y gastric bypass (RYGB) requiring Endoscopic Retrograde Cholangiopancreatography (ERCP), outlining the anatomy, indications, and various options for ERCP in such cases. ERCP is a therapeutic procedure used for conditions like choledocholithiasis, biliary complications, and pancreatitis management. The document explores three main approaches for ERCP in RYGB patients: Balloon enteroscopy assisted ERCP, Endoscopic ultrasound directed transGastric ERCP (EDGE), and Lap-assisted ERCP, highlighting the pros and cons of each method. The complication rates associated with different approaches are also outlined, along with considerations like the need for cholecystectomy, potential repeat procedures, and urgency of the intervention. The best approach depends on local resources, endoscopist expertise, patient preferences, and clinical needs. The document emphasizes shared decision-making with patients to determine the most suitable ERCP approach. References to recent studies on these techniques are provided for further exploration.

Asset Subtitle

Katelyn Cookson, PA-C

Keywords

Roux-en-Y gastric bypass

Endoscopic Retrograde Cholangiopancreatography

ERCP

choledocholithiasis

biliary complications

pancreatitis management

Balloon enteroscopy assisted ERCP

Endoscopic ultrasound directed transGastric ERCP

Lap-assisted ERCP

shared decision-making