Modified laparoscopic Janeway gastrostomy: a novel adjunct for the management of choledocholithiasis in Roux-en-Y patients

A 76-year-old woman with surgical history of Roux-en-Y gastric bypass presented with recurrent choledocholithiasis. Double balloon enteroscopy was unsuccessful in cannulating the biliary tree, thus, requiring surgically assisted endoscopic retrograde cholangiopancreaticogram (ERCP) access. Due to he...

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Bibliographic Details
Published in:BMJ case reports 2018-09, Vol.2018, p.bcr-2018-227442
Main Authors: Robalino, Ryan, Liu, Shinban, Ferzli, George
Format: Article
Language:English
Subjects:
Abdomen
Aged
Bile
Case reports
Cholangiopancreatography, Endoscopic Retrograde - methods
Cholangiopancreatography, Magnetic Resonance - methods
Choledocholithiasis - diagnostic imaging
Choledocholithiasis - surgery
Disease control
Double-Balloon Enteroscopy - methods
Endoscopy
Female
Gastric Bypass - adverse effects
Gastrointestinal surgery
Gastrostomy - methods
Gastrostomy - trends
Humans
Laparoscopy
Laparoscopy - methods
Laparoscopy - trends
Metabolism
Novel Treatment (New Drug/Intervention
Established Drug/Procedure in New Situation)
Obesity
Ostomy
Pathology
Patients
Postoperative Complications - surgery
Recurrence
Treatment Outcome
Weight control
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Description
Summary:A 76-year-old woman with surgical history of Roux-en-Y gastric bypass presented with recurrent choledocholithiasis. Double balloon enteroscopy was unsuccessful in cannulating the biliary tree, thus, requiring surgically assisted endoscopic retrograde cholangiopancreaticogram (ERCP) access. Due to her stable clinical status, the non-urgent indication and multiple anticipated ERCPs for definitive biliary clearance, a more durable port of access to the ampulla was desired. A modified laparoscopic Janeway gastrostomy of the gastric remnant was performed and served as access for multiple subsequent endoscopic procedures with successful clearance of the biliary tree.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-227442