Laparoscopic-assisted ERCP is a safe procedure with good outcomes: experience from a single high-volume upper GI unit

INTRODUCTION: Patients who have undergone Roux-en-Y gastric bypass (RYGB) no longer have anatomy that is amenable to trans-oral endoscopic retrograde cholangio-pancreatogram (ERCP). Laparoscopic-assisted ERCP (LA-ERCP), which combines laparoscopic and endoscopic techniques to access the patient's biliary tree, is a possible solution. Historically, there have been concerns about the safety and feasibility of this procedure. The aim of this case series is to explore the outcomes of LA-ERCP at a single high-volume centre. METHODS: This is a retrospective case series of all patients undergoing LA-ERCP at a single high-volume UK centre between 2015 and 2024. RESULTS: A total of 17 patients underwent 19 LA-ERCPs during the above time period. Of the 19 LA-ERCPs, 16 were completed successfully with no complications and the majority of patients were discharged home within four days post-procedure. This is the largest reported UK cohort of patients who have undergone LA-ERCP. CONCLUSION: LA-ERCP is an effective, safe and viable option for patients who are unable to undergo trans-oral ERCP.