Transjejunal Laparoscopic-Assisted ERCP: a Technique to Deal with Choledocholithiasis After Roux-En-Y Reconstruction

Introduction In Roux-en-Y reconstructions, choledocholithiasis could represent a really challenging condition to treat which can be treated by a surgical-assisted ERCP. Only six cases of transjejunal laparoscopic-assisted ERCP (LAERCP) can be found in literature to date and no large series are present.Methods A young woman who had undergone a laparoscopic Roux-en-Y gastric bypass 2years earlier came complaining recurrent abdominal pain. Radiologic exams found stones in the common bile duct and no signs of internal hernia. We therefore decided to perform a transjejunal LAERCP finding a concomitant internal hernia in the Petersen's space which was repaired at the same time.Results The post-operative course was uneventful.Conclusion Transjejunal LAERCP is a feasible technique to deal with choledocholithiasis, and it allows at the same time to identify and treat concomitant conditions like internal hernias.