Some patients who have had gastric bypass surgery for weight loss can develop tumors, gallstones or obstructions in the bile or pancreatic ducts that require additional surgery. Surgeons can access the bypassed stomach using a new minimally invasive procedure called endoscopic ultrasound-directed transgastric ERCP (EDGE) to diagnose and remove any of these.
How It Works
People who have had gastric bypass cannot have a traditional retrograde cholaniopancreatography (ERCP) to diagnose and treat problems of the liver, gall bladder, bile ducts and pancreas because a portion of their stomach has been disconnected from their digestive system. For them, EDGE is a less invasive solution.
As part of the EDGE procedure, a surgeon will work through the patient’s mouth to place a stent connecting the gastric pouch created during bypass surgery to the portion of the stomach that had been excluded through the same procedure. The ERCP can then be performed.
The stent will remain in place for several months. You will need to return to have it removed and we will use imaging to ensure the connection between the gastric pouch and stomach closes again.
Pros
Benefits of the EDGE procedure can include:
- 100% success rate
- No incision is required
- Patients typically go home the day after
Cons
Your surgeon will also discuss with you any cons of EDGE, which can include:
- Needing to return several months after the tumor or blockage is addressed using EDGE to have the stent removed.
Risks
EDGE complications are similar to other endoscopic procedures, including:
- Bleeding
- Infection
- Perforation
- Stent misplacement