This case involves a 62-year-old female patient who was subjected to a gastric bypass two years ago. She came to the emergency department hospital complaining that she had had abdominal pain and jaundice for two days.

Her laboratory results showed elevated liver enzymes and a high conjugated bilirubin count.

An MRI revealed a CBD dilation of up to 14 mm. It also showed multiple filling defects in the gallbladder and a stone in the CBD measuring 14 mm.

As you can see in the video a trans-gastric ERCP + biliary lithiasis treatment + simultaneous cholecystectomy was carried with good outcomes.

Would you follow a different strategy?

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Dr. Ricardo V. Cohen MD, PhD, IFSO President; Director, Obesity and Diabetes Center, Hospital Alemão Oswaldo Cruz, Brazil Bariatric Surgery