{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T01:06:14Z","timestamp":1784768774582,"version":"3.55.0"},"reference-count":15,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T00:00:00Z","timestamp":1565740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Nowadays, with the increasing laparoscopic expertise and accessibility to modern surgical tools, laparoscopic assisted ERCP (LAERCP) has become an effective approach for the management of bile stone disease in patients with modified gastrointestinal anatomy. In contrast to patients with gastric bypass in whom a transgastric LAERCP approach is usually performed, the resultant anatomy of Roux-en-Y hepaticojejunostomy precludes a gastric approach as the newly formed bilioenteric anastomosis is not reachable through the stomach. Therefore, a transjejunal approach has been described as an alternative LAERCP technique. To the best of our knowledge this is the tenth case of transjejunal LAERCP reported worldwide. Materials and Methods: We present the case of a 50-year-old female with history of biliary injury during a cholecystectomy corrected with Roux-en-Y hepaticojejunostomy who presented to our center with manifestations of acute abdomen. After laboratory and image analysis, diagnosis of intrahepatic lithiasis was confirmed. The decision to perform a transjejunal LAERCP was made due to the complex anatomy in this patient. No complications were found during surgery and in the follow up period. Conclusions: Transjejunal LAERCP is an effective approach for endoscopic management of biliary complications in patients with Roux-en-Y hepaticojejunostomy and other modified gastrointestinal anatomy. Previous recommendations by more experienced teams have been reported, nonetheless, there are too few cases reported to make definitive recommendations and conclusions. In limited settings, such as ours, some of these recommendations may not be applicable. We are certain that, with the increasing expertise and innovations in laparoscopy surgery for the management of complications that cannot be addressed by endoscopic or noninvasive measures, more cases will be reported.<\/jats:p>","DOI":"10.3390\/medicina55080483","type":"journal-article","created":{"date-parts":[[2019,8,15]],"date-time":"2019-08-15T04:22:54Z","timestamp":1565842974000},"page":"483","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Transjejunal Laparoscopic Assisted ERCP in a Patient with Roux-en-Y Hepaticojejunostomy"],"prefix":"10.3390","volume":"55","author":[{"given":"Adrian A.","family":"Baca-Arzaga","sequence":"first","affiliation":[{"name":"Escuela Nacional de Medicina, Tecnologico de Monterrey, Monterrey 64710, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector","family":"Navarro-Chavez","sequence":"additional","affiliation":[{"name":"Hospital Regional ISSSTE Monterrey, Monterrey 66603, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus","family":"Galindo-Jimenez","sequence":"additional","affiliation":[{"name":"Hospital Regional ISSSTE Monterrey, Monterrey 66603, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3150-5365","authenticated-orcid":false,"given":"Jose","family":"Santibanez-Juarez","sequence":"additional","affiliation":[{"name":"Escuela Nacional de Medicina, Tecnologico de Monterrey, Monterrey 64710, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Cardosa-Gonzalez","sequence":"additional","affiliation":[{"name":"Hospital Regional ISSSTE Monterrey, Monterrey 66603, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6048-5957","authenticated-orcid":false,"given":"Eduardo","family":"Flores-Villalba","sequence":"additional","affiliation":[{"name":"Escuela Nacional de Medicina, Tecnologico de Monterrey, Monterrey 64710, Mexico"},{"name":"Escuela Nacional de Ingenier\u00eda, Tecnologico de Monterrey, Monterrey 64849, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Sultan, A.M., Elshobary, M.M., Askar, W., El Nakeeb, A., Abdelrafee, A., Atef, E., Ezzat, H., Fathy, O., and Abdel Wahab, M. (2019). Risk Factors and Predictors of Poor Outcome Following Hepaticojejunostomy for Postcholecystecomy Bile Duct Injury. Indian J. Surg.","DOI":"10.1007\/s12262-019-01866-8"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1016\/j.gie.2017.10.044","article-title":"Multicenter evaluation of the clinical utility of laparoscopy-assisted ERCP in patients with Roux-en-Y gastric bypass","volume":"87","author":"Abbas","year":"2018","journal-title":"Gastrointest. Endosc."},{"key":"ref_3","first-page":"e1","article-title":"Transjejunal laparoscopic-assisted ERCP in Roux-en-Y patient: The new right path","volume":"101","author":"Mita","year":"2018","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Dalmonte, G., Valente, M., Bosi, S., Gnocchi, A., and Marchesi, F. (2019). Transjejunal Laparoscopic-Assisted ERCP: A Technique to Deal with Choledocholithiasis After Roux-En-Y Reconstruction. Obes. Surg.","DOI":"10.1007\/s11695-019-03882-9"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.1097\/SLE.0000000000000397","article-title":"Transenteric ERCP for treatment of choledocholithiasis after duodenal switch","volume":"27","author":"Marchesini","year":"2017","journal-title":"Surg. Laparosc. Endosc. Percutan. Tech."},{"key":"ref_6","first-page":"1","article-title":"Laparoscopy-assisted transjejunal ERCP in a patient with roux-en-Y gastric bypass","volume":"12","author":"Surdeanu","year":"2016","journal-title":"Acta. Chir. Belg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1089\/lap.2009.0020","article-title":"Laparoscopy-Assisted Transjejunal ERCP in a Patient with Roux-en-Y Reconstruction Following Partial Gastrectomy","volume":"20","author":"Lopes","year":"2010","journal-title":"J. Laparoendosc. Adv. Surg. Tech."},{"key":"ref_8","first-page":"69","article-title":"Laparoscopy assisted transjejunal ERCP for treatment of pancreaticopleural fistula","volume":"11","author":"Saleem","year":"2010","journal-title":"J. Pancreas."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s11695-007-9026-1","article-title":"Laparoscopy-assisted ERCP after biliopancreatic diversion","volume":"17","author":"Mutignani","year":"2007","journal-title":"Obes. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"104","DOI":"10.15537\/smj.2015.1.10404","article-title":"Laparoscopy assisted transjejunal endoscopic retrograde cholangiography for treatment of intrahepatic duct stones in a post Roux-en-y patient","volume":"36","author":"Mansor","year":"2015","journal-title":"Saudi. Med. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1007\/s00464-015-4323-6","article-title":"Effectiveness of peroral direct cholangioscopy using an ultraslim endoscope for the treatment of hepatolithiasis in patients with hepaticojejunostomy (with video)","volume":"30","author":"Matsumoto","year":"2016","journal-title":"Surg. Endosc."},{"key":"ref_12","first-page":"38","article-title":"Comparatively lower postoperative hepatolithiasis risk with hepaticocholedochostomy versus hepaticojejunostomy","volume":"9","author":"Zhang","year":"2010","journal-title":"Hepatobiliary Pancreat. Dis. Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.gie.2015.02.013","article-title":"Systematic review and meta-analysis of single-balloon enteroscopy-assisted ERCP in patients with surgically altered GI anatomy","volume":"82","author":"Inamdar","year":"2015","journal-title":"Gastrointest. Endosc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"4064","DOI":"10.1007\/s11695-018-3507-2","article-title":"Comparison between Enteroscopy-Based and Laparoscopy-Assisted for Accessing the Biliary Tree in Patients with Roux-en-Y Gastric Bypass: Systematic Review and Meta-analysis","volume":"28","author":"Bernardo","year":"2018","journal-title":"Obes Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1177\/1756283X16674633","article-title":"A comparative evaluation of treatment methods for bile duct stones after hepaticojejunostomy between percutaneous transhepatic cholangioscopy and peroral, short double-balloon enteroscopy","volume":"10","author":"Tsutsumi","year":"2017","journal-title":"Therap. Adv. Gastroenterol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/55\/8\/483\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:11:07Z","timestamp":1760188267000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/55\/8\/483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,14]]},"references-count":15,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2019,8]]}},"alternative-id":["medicina55080483"],"URL":"https:\/\/doi.org\/10.3390\/medicina55080483","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,14]]}}}