{
  "abstract": "Introduction Laparoscopy-assisted ERCP (LA-ERCP) is an established approach to achieve duodenal access and perform therapeutic ERCP in patients with surgically altered upper gastrointestinal anatomy (e.g., Roux-en-Y reconstruction). 1 Multi-centre UK experience remains limited. We describe outcomes from a multicentre UK series of LA-ERCPs performed across five centres located in the Northeast of UK.Methods Retrospective multicentre case series of consecutive patients undergoing LA-ERCP between September 2020 up to August 2025 at Northumbria, Sunderland, Freeman, NorthTees and Jamescook Hospitals. Thirty-eight consecutive patients undergoing LA-ERCP were included. Data were collected on demographics, indications, imaging, baseline bloods, procedural success, adverse events, and hospital stay. Technical success was defined as successful cannulation of the papilla; therapeutic success was defined as successful stone removal or other definitive intervention.Results A total of 38 LA-ERCPs were performed. The median age was 59 years (IQR 54-67). The cohort was predominantly female (23/38, 60.5%). Common indications included choledocholithiasis and cholangitis. Pre-procedure MRCP was performed in the majority of cases. Median bilirubin was 16.5 µmol/L (IQR 12-54.5) and ALP 286.5 U/L (IQR 173-625.5).Technical success (cannulation) was achieved in 37/38 (97.4%) cases with a single case of successful cannulation but unsafe sphincterotomy . Therapeutic success (stone removal) was achieved in 33/38 (86.8%) cases. Three cases (7.9%) were classified as procedure failure, which included the failed sphincterotomy case and two cases that required subsequent surgical management despite initial cannulation.Complications included pancreatitis (1 case, 2.6%), bleeding (2 cases, 5.3%), and surgical adverse events (1 case, 2.6%). No cases of post-ERCP cholangitis or perforation were recorded. The median length of stay was 2 days (IQR 1–4).Conclusions In this multicentre UK series in the Northeast, LA-ERCP demonstrates a very high technical success rate (97.4%) and an acceptable therapeutic success rate. The complication profile is favourable, with low rates of post-ERCP pancreatitis and bleeding, and no perforations. LA-ERCP offers a reliable and safe alternative for biliary access post-RYGB in centres with appropriate expertise.Reference Kedia P, Tarnasky PR, Nieto J, Steele SL, Siddiqui A, Xu MM, et al. EUS-directed transgastric ERCP (EDGE) versus laparoscopy-assisted ERCP (LA-ERCP) for Roux-en-Y gastric bypass (RYGB) anatomy: a systematic review and meta-analysis. Gastrointest Endosc. 2020;91(3):538–47.Abstract P21 Table 1Outcome of the study populationOutcomeCount/TotalRate (%)Technical Success (Cannulation)37/3897.4%Therapeutic Success (Stone Removal)33/3886.8%Procedure Failure3/387.9%Post-ERCP Pancreatitis1/382.6%Bleeding2/385.3%Perforation0/380.0%Cholangitis0/380.0%Surgical Adverse Events1/382.6%",
  "authors": [
    {
      "affiliations": [
        "South Tees NHS Foundation Trust, Middlesbrough, United Kingdom"
      ],
      "name": "Mahmoud Mohamed"
    },
    {
      "affiliations": [
        "South Tees NHS Foundation Trust, Middlesbrough, United Kingdom"
      ],
      "name": "Ramy ElHusseiny"
    },
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, Newcastle, United Kingdom"
      ],
      "name": "Mohamed Mohamed"
    },
    {
      "affiliations": [
        "South Tees NHS Foundation Trust, Middlesbrough, United Kingdom"
      ],
      "name": "Mohamed Talkhan"
    },
    {
      "affiliations": [
        "South Tees NHS Foundation Trust, Middlesbrough, United Kingdom"
      ],
      "name": "Ayman Namera"
    },
    {
      "affiliations": [
        "North Tees University Hospital, Stockton-on-Tees, United Kingdom"
      ],
      "name": "Daniel Stokes"
    },
    {
      "affiliations": [
        "County Durham and Darlington NHS Foundation Trust, Durham, United Kingdom"
      ],
      "name": "Mohamed Zinalabadin"
    },
    {
      "affiliations": [
        "Gateshead NHS Foundation Trust, Gateshead, United Kingdom"
      ],
      "name": "Attit Ghoda"
    },
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, Newcastle, United Kingdom"
      ],
      "name": "Laura Kenny"
    },
    {
      "affiliations": [
        "The Newcastle upon Tyne NHS Foundation Trust, Newcastle, United Kingdom"
      ],
      "name": "Ayman Mohamed"
    },
    {
      "affiliations": [
        "North Tees University Hospital, Stockton-on-Tees, United Kingdom"
      ],
      "name": "Vikram Mitra"
    },
    {
      "affiliations": [
        "The Newcastle upon Tyne NHS Foundation Trust, Newcastle, United Kingdom"
      ],
      "name": "John Leeds"
    }
  ],
  "title": "P21 Laparoscopy-assisted ERCP: a multicentre UK experience",
  "uid": "4a3e9133-3f3e-55fb-9a22-89c1943a315f"
}