Introduction.

Patients with a history of gastric bypass who present with choledocholithiasis cannot be treated with the conventional technique of endoscopic retrograde cholangiopancreatography. In these cases, the open or laparoscopic-assisted transgastric approach becomes an excellent alternative to open bile duct gastric exploration.

Methods.

A retrospective review of patients with choledocholithiasis and a history of subtotal gastrectomy or gastric bypass with Roux-en-Y, who underwent laparo-assisted transgastric endoscopic cholangiopancreatography, was conducted between January 2019 and December 2021 at Clínica CES de Medellín, Colombia.

Results.

Seven patients were found, all with a history of gastric bypass secondary to obesity. The rate of bile duct identification and cannulation, and stone removal was 100% using the laparo-assisted transgastric approach.

Conclusion.

According to several systematic reviews, this technique is relatively easy to implement and safe, presenting a rate of complications less than 5%. A variant to this technique is proposed.

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