Grandview Team Performs First EDGE Procedure

8/7/2023

BIRMINGHAM, AL (August 7, 2023) – Grandview Medical Center’s endoscopy team recently performed the hospital’s first endoscopic ultrasound (EUS) directed transgastric ERCP, known as the EDGE procedure. This innovative procedure allows access to the bile ducts and pancreas in patients with Roux-en-Y gastric bypass (RYGB). Currently, only a few medical centers in the country perform this procedure.

Patients with RYGB are at an increased risk for developing bile duct stones. They can also be diagnosed with pancreatic cysts, bile duct cancer, or pancreatic cancer.

“These conditions require a variety of complex endoscopic procedures such as EUS and ERCP,” explains Mohannad Dugum, M.D., gastroenterologist and director of advanced endoscopy at Grandview Medical Center. “However, management of pancreatic and biliary diseases in patients with RYGB has been historically challenging due to the altered anatomy prohibiting direct endoscopic access to the pancreas and bile ducts. Traditional options include the utilization of long endoscopes or surgical assistance through laparoscopic-assisted ERCP. The former option has relatively low technical success rates, while the latter introduces additional risks related to surgery.”

The EDGE procedure involves creation of a temporary tract by placing a metal stent under EUS guidance into the excluded stomach, allowing a direct pathway for performing ERCP or EUS. “This is a minimally invasive endoscopic procedure that is a safe alternative to surgical intervention. It is performed on an outpatient basis with excellent success rate and safety profile,” says Dr. Dugum.

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