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Endoscopic biliary therapy in the era of bariatric surgery
  1. Harry Martin1,
  2. Tareq El Menabawey1,
  3. Orla Webster2,
  4. Constantinos Parisinos1,
  5. Michael Chapman1,
  6. Stephen P Pereira1,3,
  7. Gavin Johnson1,
  8. George Webster1
  1. 1Pancreaticobiliary Medicine, University College London Hospitals, London, UK
  2. 2University of Bristol Medical School, Bristol, Bristol, UK
  3. 3University College London Medical School, The UCL Institute of Hepatology, London, UK
  1. Correspondence to Dr George Webster, Gastroenterology, University College London Hospital NHS Foundation Trust, London, London NW1 2PG, UK; george.webster1{at}


There is an increasing demand and availability of bariatric surgery, with a range of procedures performed, some leading to altered upper gastrointestinal anatomy. The patient population undergoing bariatric surgery is also at increased risk of gallstones and biliary stone disease. Endoscopy (ie, endoscopic retrograde cholangiopancreatography) is the cornerstone of management of biliary stone disease, but may be challenging after bariatric surgery. In this review the endoscopic, surgery assisted, or percutaneous options that may be considered are discussed, based on the details of surgical anatomy and available expertise.

  • gallstones
  • bile duct stones
  • obesity surgery
  • endoscopic retrograde pancreatography
  • endoscopic ultrasonography

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  • Twitter @PereiraGroup, @GWebster_endo

  • Contributors GW conceived the review and is guarantor for the text. HM was lead author for preparing the text. TEM and CP led on section writing. OW designed and created the figures. MC, SPP and GJ were involved in critical review and article editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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