ERCP in patients with Roux-en-Y gastric bypass: one size does not fit all

The study by Bukhari et al1 comparing EUS-guided gastrostomy-assisted ERCP (EUS-GG-ERCP) versus enteroscopy-assisted ERCP (e-ERCP) in patients with Roux-en-Y gastric bypass (RYGB) contributes new and important information on the care of these challenging patients. Technical success was significantly higher with EUS-GG-ERCP (100% vs 60%; P < .001), whereas procedure time and hospital stay were significantly lower. The adverse events rate was similar in the 2 groups (10% vs 6.7%; P = 1).

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