Abstract
Pancreaticobiliary access in patients with Roux-en-Y gastric bypass (RYGB) poses a significant challenge for therapeutic endoscopists. With the advent of lumen-apposing metal stents (LAMS), EUS-directed transgastric ERCP (EDGE) procedures have gained popularity as a favorable alternative to laparoscopy and enteroscopy assisted ERCP. Thus far, there have widely varied intervals between steps and adverse event rates reported. In addition, there have been few reports with use of 20 mm LAMS, hence it’s procedural and peri-procedural impact remains unknown.
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