This is not a procedure that is frequently required. Endoscopic retrograde cholopancreatography or ERCP is a special endoscopic procedure which does not usually require surgery and is performed by a gastroenterologist in order to remove trapped gallstones from the main bile duct. If however the patient has undergone in the past Roux-en-Y gastric bypass, then the procedure cannot be performed endoscopically by mouth. In such instances the procedure requires the involvement of a surgeon who will provide access laparoscopically at the bypassed segment of the stomach so the gastroenterologist can perform the ERCP. Professor Raftopoulos has extensive experience in this unique and rather rare procedure and it can be performed laparoscopically. For more information please contact our office.