Laparoscopically assisted ERCP in a case of acute cholangitis in a patient with biliopancreatic diversion with distal gastric preservation.

Roux-en-Y gastric bypass, biliopancreatic diversion (BPD; Scopinaro's technique), and BPD with distal gastric preservation (BPDGP) are different surgical procedures, currently performed with laparoscopic assistance, successfully used as a treatment for morbid obesity. All of these modalities bear the burden of a difficult access when it comes to explore and work within the biliary tract. We present a case of acute cholangitis due to choledocholithiasis in a patient with BPDGP for morbid obesity successfully managed by laparoscopy-assisted endoscopic retrograde cholangiopancreatography through the gastric remnant.