Grandview Medical Center’s Endoscopy team recently performed the hospital’s first endoscopic ultrasound (EUS) directed transgastric ERCP, known as the EDGE procedure. This procedure allows access to the bile ducts and pancreas in patients with Roux-en-Y Gastric Bypass (RYGB). Currently, only a few medical centers in the country perform this procedure. Patients with RYGB are at an increased risk for developing bile duct stones. They can also be diagnosed with pancreatic cysts, bile duct cancer, or pancreatic cancer.

“These conditions require a variety of complex endoscopic procedures such as EUS and ERCP,” said Mohannad Dugum, MD, Director of Advanced Endoscopy at Grandview. “However, management of pancreatic and biliary diseases in patients with RYGB has been historically challenging due to the altered anatomy prohibiting direct endoscopic access to the pancreas and bile ducts. Traditional options include the utilization of long endoscopes or surgical assistance through laparoscopic-assisted ERCP. The former option has relatively low technical success rates, while the latter introduces additional risks related to surgery.”