Endoscopic retrograde cholangiopancreatography in Roux-en-Y gastric bypass patients

Roux-en-Y gastric bypass surgery remains a popular surgical intervention worldwide to treat morbid obesity. It is effective and relatively safe. However, one of the results related to bariatric surgery-induced rapid weight loss is the development of biliary stones. Endoscopic removal of common bile duct stones is challenging in patients with Roux-en-Y gastric bypass reconstruction. The current review highlights the different endoscopic approaches of the biliopancreatic system to perfomt endoscopic retrograde cholangiopancreatography in patients with Roux-en-Y gastric bypass. A treatment algorithm is provided based on clinical indications.