Laparoscopic-assisted endoscopic retrograde cholangiopancreatography post bariatric surgery: how to overcome the technical challenges

The prevalence of bariatric surgery is increasing worldwide and as a direct consequence, there shall be an increasing number of patients presenting with the complications of bariatric surgery, often to non-specialist units. The authors report a case of a 42-year-old Caucasian female who had previous laparoscopic Roux-en-Y gastric bypass, open cholecystectomy and abdominoplasty presenting with right upper quadrant pain in keeping with retained common bile duct stones. After the failure of conservative management, a laparoscopic-assisted transgastric endoscopic retrograde changiopancreatography and sphincterotomy was performed. We shall be describing our technique.