Access to excluded structures after Roux-en-Y gastric bypass: Experience in a high-level bariatric center without a technical platform for endoscopic retrograde cholangiopancreatography

If access to excluded structures and simultaneous ERCP was not possible, temporary laparoscopic Janeway gastrostomy could be the last option alternative for a staged ERCP to gain access to the bypassed structures. It is a feasible and safe solution for the exploration and treatment of patients with a history of RYGBP in bariatric centers that have no endoscopists with expertise in ERCP.