Endoscopic Management of Afferent Loop Syndrome after a Pylorus Preserving Pancreatoduodenecotomy Presenting with Obstructive Jaundice and Ascending Cholangitis.
- Author:
Jae Kyung KIM
1
;
Chan Hyuk PARK
;
Ji Hye HUH
;
Jeong Youp PARK
;
Seung Woo PARK
;
Si Young SONG
;
Jaebock CHUNG
;
Seungmin BANG
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. bang7028@yuhs.ac
- Publication Type:Case Report
- Keywords:
Afferent loop syndrome;
Endoscopic treatment;
Pylorus preserving pancreaticoduodenectomy;
Obstructive jaundice
- MeSH:
Afferent Loop Syndrome;
Cholangitis;
Endoscopes;
Gastric Bypass;
Humans;
Jaundice, Obstructive;
Pancreatic Neoplasms;
Pancreaticoduodenectomy;
Pylorus;
Recurrence;
Stents
- From:Clinical Endoscopy
2011;44(1):59-64
- CountryRepublic of Korea
- Language:English
-
Abstract:
Afferent loop syndrome is a rare complication of gastrojejunostomy. Patients usually present with abdominal distention and bilious avomiting. Afferent loop syndrome in patients who have undergone a pylorus preserving pancreaticoduodenectomy can present with ascending cholangitis. This condition is related to a large volume of reflux through the biliary-enteric anastomosis and static materials with bacterial overgrowth in the afferent loop. Patients with afferent loop syndrome after pylorus preserving pancreaticoduodenectomy frequently cannot be confirmed as surgical candidates due to poor medical condition. In that situation, a non-surgical palliation should be considered. Herein, we report two patients with afferent loop syndrome presenting with obstructive jaundice and ascending cholangitis. The patients suffered from the recurrence of pancreatic cancer after pylorus preserving pancreaticoduodenectomy. The diagnosis of afferent loop syndrome was confirmed, and the patients were successfully treated by inserting an endoscopic metal stent using a colonoscopic endoscope.
