Endoscopic ultrasound-directed transgastric ERCP for disconnected pancreatic duct syndrome: finding the edge to bridge the gap

Altered anatomy from Roux-en-Y gastric bypass makes access to the papilla difficult. Solutions such as balloon-assisted and laparoscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP) are complicated by sub-optimal technical success and adverse event rates [1]. EUS-directed transgastric ERCP (EDGE) is a promising solution with high technical and clinical success rates [2] and provides ease of access if multiple procedures are required.