How I treat... choledocholithiasis by retrograde cholangiopancreatography in a patient with gastric bypass

Performing endoscopic retrograde cholangiopancreatography (ERCP) in bariatric patients with gastric bypass is often challenging. Many techniques have been described. Recently, Endoscopic ultrasound (EUS) - direct transgastric ERCP (EDGE) by using lumen-apposing metal stent (LAMS) has shown efficacy to reach biliary orifice and perform conventional ERCP with good safety profile and low risk of adverse events.