Clinical Endoscopy

Focused Review Series: Endoscopic Management of Postoperative Gastrointestinal Complication: What’s New?

Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome: Hideyuki Shiomi, Arata Sakai, Ryota Nakano, Shogo Ota, Takashi Kobayashi, Atsuhiro Masuda, Hiroko Iijima; Clin Endosc 2021;54(6):810-817. Published online November 15, 2021; DOI: https://doi.org/10.5946/ce.2021.234

Afferent loop syndrome (ALS) is a mechanical obstruction of the afferent limbs after gastrectomy with gastrojejunostomy reconstruction. Patients with cancer recurrence require immediate and less invasive treatment because of their poor condition. Percutaneous transhepatic/transluminal drainage (PTD) and endoscopic enteral stenting offer reasonable palliative treatment for malignant ALS but are not fully satisfactory in terms of patient quality of life (QoL) and stent patency. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using a lumen-apposing metal stent may address these shortcomings. Clinical data from 11 reports showed that all patients who had undergone EUS-GE had positive technical and clinical outcomes. The adverse event rate was 11.4%, including only mild or moderate abdominal pain, with no severe adverse events. Indirect comparative studies indicated that patients who had undergone EUS-GE had a significantly superior QoL, a higher clinical success rate, and a lower reintervention rate than those who had undergone PTD or endoscopic enteral stenting. Although the evidence is limited, EUS-GE may be considered as a first-line treatment for malignant ALS because it has better clinical outcomes than other less invasive treatments, such as PTD or endoscopic enteral stenting. Further prospective randomized control trials are necessary to establish EUS-GE as a standard treatment for ALS.

Citations

Citations to this article as recorded by

Endoscopic ultrasound-guided gastroenterostomy, with focus on technique and practical tips
Chi-Ying Yang, Wen-Hsin Huang, Hsing-Hung Cheng
Clinical Endoscopy.2025; 58(2): 201. CrossRef
Endoscopic ultrasound‐guided gastrointestinal anastomosis: Are we there yet?
Vinay Dhir, Cesar Jaurrieta‐Rico, Vivek Kumar Singh
Digestive Endoscopy.2024; 36(9): 981. CrossRef
Endoscopic ultrasound-guided gastroenterostomy using a novel dumbbell-shaped fully covered metal stent for afferent loop syndrome with long interluminal distance
Hideyuki Shiomi, Ryota Nakano, Shogo Ota, Hiroko Iijima
Endoscopy.2023; 55(S 01): E362. CrossRef
Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience
Saburo Matsubara, Sho Takahashi, Naminatsu Takahara, Keito Nakagawa, Kentaro Suda, Takeshi Otsuka, Yousuke Nakai, Hiroyuki Isayama, Masashi Oka, Sumiko Nagoshi
Journal of Clinical Medicine.2023; 12(10): 3524. CrossRef
Endoscopic ultrasound guided gastroenterostomy: Technical details updates, clinical outcomes, and adverse events
Jian Wang, Jin-Long Hu, Si-Yu Sun
World Journal of Gastrointestinal Endoscopy.2023; 15(11): 634. CrossRef
Endoscopic ultrasound-guided intra-afferent loop entero-enterostomy using a forward-viewing echoendoscope and insertion of a metal stent
Yuki Kawasaki, Susumu Hijioka, Kosuke Maehara, Kiichi Tamada, Takuji Okusaka, Yutaka Saito
Endoscopy.2022; 54(S 02): E815. CrossRef
Endoscopic ultrasound‐guided gastrojejunostomy for malignant afferent loop syndrome with hemorrhage in a patient with recurrent peritoneal dissemination
Kenjiro Yamamoto, Takayoshi Tsuchiya, Ryosuke Tonozuka, Shuntaro Mukai, Hiroyuki Kojima, Noriyuki Hirakawa, Takao Itoi
Journal of Hepato-Biliary-Pancreatic Sciences.2022;[Epub] CrossRef
Current status of, and challenges posed by, endoscopic ultrasound‐guided anastomosis of the digestive tract in patients with afferent loop syndrome
Toshio Fujisawa, Hiroyuki Isayama
Digestive Endoscopy.2022; 34(7): 1440. CrossRef

5,138 View
167 Download
8 Web of Science
8 Crossref

Case Reports

Metal Stent Placement in the Afferent Loop Obstructed by Peritoneal Metastases—Experience of Five Cases: Yoshihide Kanno, Tetsuya Ohira, Yoshihiro Harada, Yoshiki Koike, Taku Yamagata, Megumi Tanaka, Tomohiro Shimada, Kei Ito; Clin Endosc 2018;51(3):299-303. Published online April 18, 2018; DOI: https://doi.org/10.5946/ce.2018.005

Abstract PDF PubReader ePub

Afferent loop syndrome is often difficult to resolve. Among patients with afferent loop syndrome whose data were extracted from databases, 5 patients in whom metal stent placement was attempted were included and evaluated in this study. The procedure was technically successful without any adverse events in all patients. Metal stent(s) was placed with an endoscope in the through-the-scope manner in 4 patients and via a percutaneous route in 1 patient. Obvious clinical efficacy was observed in all patients. Adverse events related to the procedure and stent occlusion during the follow-up period were not observed. Metal stent placement for malignant obstruction of the afferent loop was found to be safe and feasible.

Citations

Citations to this article as recorded by

Early and late effects of endoscopic interventions in patients with malignant afferent loop syndrome: A single‐center experience and literature review
Kenjiro Yamamoto, Takao Itoi, Yukitoshi Matsunami, Atsushi Sofuni, Takayoshi Tsuchiya, Shuntaro Mukai, Hiroyuki Kojima, Hirohito Minami, Ryosuke Nakatsubo, Ryosuke Tonozuka
Journal of Hepato-Biliary-Pancreatic Sciences.2024; 31(2): 120. CrossRef
Efficacy of endoscopic ultrasound‐guided gastroenterostomy using self‐expandable metallic stent for afferent loop syndrome: A single‐center retrospective study
Yuya Hagiwara, Susumu Hijioka, Yoshikuni Nagashio, Yuta Maruki, Akihiro Ohba, Yuki Kawasaki, Kotaro Takeshita, Tetsuro Takasaki, Daiki Agarie, Hidenobu Hara, Shin Yagi, Soma Fukuda, Masaru Kuwada, Daiki Yamashige, Kohei Okamoto, Mark Chatto, Shunsuke Kond
Journal of Gastroenterology and Hepatology.2024; 39(10): 2136. CrossRef
Efficacy and safety of endoscopic stent placement for afferent loop obstruction using a short double‐balloon endoscopy
Takashi Ito, Masaaki Shimatani, Masataka Masuda, Koh Nakamaru, Toshiyuki Mitsuyama, Norimasa Fukata, Tsukasa Ikeura, Makoto Takaoka, Kazuichi Okazaki, Makoto Naganuma
DEN Open.2023;[Epub] CrossRef
Endoscopic Transluminal Stent Placement for Malignant Afferent Loop Obstruction
Chinatsu Yonekura, Takashi Sasaki, Takafumi Mie, Takeshi Okamoto, Tsuyoshi Takeda, Takaaki Furukawa, Yuto Yamada, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira
Journal of Clinical Medicine.2022; 11(21): 6357. CrossRef
Clinical management for malignant afferent loop obstruction
Arata Sakai, Hideyuki Shiomi, Atsuhiro Masuda, Takashi Kobayashi, Yasutaka Yamada, Yuzo Kodama
World Journal of Gastrointestinal Oncology.2021; 13(7): 509. CrossRef
Clinical management for malignant afferent loop obstruction
Arata Sakai, Hideyuki Shiomi, Atsuhiro Masuda, Takashi Kobayashi, Yasutaka Yamada, Yuzo Kodama
World Journal of Gastrointestinal Oncology.2021; 13(7): 684. CrossRef
Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome
Hideyuki Shiomi, Arata Sakai, Ryota Nakano, Shogo Ota, Takashi Kobayashi, Atsuhiro Masuda, Hiroko Iijima
Clinical Endoscopy.2021; 54(6): 810. CrossRef
Usefulness of endoscopic metal stent placement for malignant afferent loop obstruction
Akihiko Kida, Hidenori Kido, Toshiki Matsuo, Atsuyoshi Mizukami, Masaaki Yano, Fumitaka Arihara, Koichiro Matsuda, Kohei Ogawa, Mitsuru Matsuda, Akito Sakai
Surgical Endoscopy.2020; 34(5): 2103. CrossRef
Endoscopic Self-Expandable Metal Stent Placement for Malignant Afferent Loop Obstruction After Pancreaticoduodenectomy: A Case Series and Review
Arata Sakai, Hideyuki Shiomi, Takao Iemoto, Ryota Nakano, Takuya Ikegawa, Takashi Kobayashi, Atsuhiro Masuda, Yuzo Kodama
Clinical Endoscopy.2020; 53(4): 491. CrossRef
Endoscopic nasogastric tube insertion for treatment of benign afferent loop obstruction after radical gastrectomy for gastric cancer
Yuning Cao, Xiangheng Kong, Daogui Yang, Senlin Li
Medicine.2019; 98(28): e16475. CrossRef
Enteral self-expandable metal stent placement for malignant afferent limb syndrome using single-balloon enteroscope: report of five cases
Kei Yane, Akio Katanuma, Tsuyoshi Hayashi, Kuniyuki Takahashi, Toshifumi Kin, Kazumasa Nagai, Kazunari Tanaka, Naohiro Komatsu, Masato Endo, Yousuke Kobayashi, Yukiko Takigawa, Ran Utsunomiya
Endoscopy International Open.2018; 06(11): E1330. CrossRef

6,256 View
111 Download
10 Web of Science
11 Crossref

Electrohydraulic Lithotripsy of an Impacted Enterolith Causing Acute Afferent Loop Syndrome: Young Sin Cho, Tae Hoon Lee, Soon Oh Hwang, Sunhyo Lee, Yunho Jung, Il-Kwun Chung, Sang-Heum Park, Sun-Joo Kim; Clin Endosc 2014;47(4):367-370. Published online July 28, 2014; DOI: https://doi.org/10.5946/ce.2014.47.4.367

Abstract PDF PubReader ePub

Afferent loop syndrome caused by an impacted enterolith is very rare, and endoscopic removal of the enterolith may be difficult if a stricture is present or the normal anatomy has been altered. Electrohydraulic lithotripsy is commonly used for endoscopic fragmentation of biliary and pancreatic duct stones. A 64-year-old man who had undergone subtotal gastrectomy and gastrojejunostomy presented with acute, severe abdominal pain for a duration of 2 hours. Initially, he was diagnosed with acute pancreatitis because of an elevated amylase level and pain, but was finally diagnosed with acute afferent loop syndrome when an impacted enterolith was identified by computed tomography. We successfully removed the enterolith using direct electrohydraulic lithotripsy conducted using a transparent cap-fitted endoscope without complications. We found that this procedure was therapeutically beneficial.

Citations

Citations to this article as recorded by

Migrated Pancreaticojejunal Stent Forming a Stent–Stone Complex in the Jejunum with Resultant Small Bowel Obstruction: A Case Report
Jiwon Kim, Young Han Kim, Byung-Hee Lee
Journal of the Korean Society of Radiology.2023; 84(2): 512. CrossRef
Use of a pneumatic device for intraluminal enterolith fragmentation in horses
Bruna Machado Amaral Rosa, Peterson Triches Dornbusch, Juan Carlos Duque Moreno, Jackson Schade
Equine Veterinary Education.2023;[Epub] CrossRef
Clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction
Shuai Wang, Xiaohui Yang, Yixiong Zheng, Yulian Wu
Journal of International Medical Research.2021;[Epub] CrossRef
Diagnosis and treatment of the afferent loop syndrome
Panotpol Termsinsuk, Tanyaporn Chantarojanasiri, Nonthalee Pausawasdi
Clinical Journal of Gastroenterology.2020; 13(5): 660. CrossRef
Cola Dissolution Therapy via Ileus Tube Was Effective for Ileus Secondary to Small Bowel Obstruction Induced by an Enterolith
Yuga Komaki, Shuji Kanmura, Akihito Tanaka, Mari Nakashima, Fukiko Komaki, Hiromichi Iwaya, Shiho Arima, Fumisato Sasaki, Yuichiro Nasu, Shiroh Tanoue, Shinichi Hashimoto, Akio Ido
Internal Medicine.2019; 58(17): 2473. CrossRef
Intestinal stones: A rare cause of bowel obstruction
Emilio de León Castorena, Miriam Daniela de León Castorena
SAGE Open Medical Case Reports.2019;[Epub] CrossRef
Afferent loop obstruction with obstructive jaundice and ileus due to an enterolith after distal gastrectomy: A case report
Koki Sato, Masataka Banshodani, Masahiro Nishihara, Junko Nambu, Yasuo Kawaguchi, Fumio Shimamoto, Keizo Sugino, Hideki Ohdan
International Journal of Surgery Case Reports.2018; 50: 9. CrossRef
Afferent Loop Syndrome after Roux-en-Y Total Gastrectomy Caused by Volvulus of the Roux-Limb
Hideki Katagiri, Kana Tahara, Kentaro Yoshikawa, Alan Kawarai Lefor, Tadao Kubota, Ken Mizokami
Case Reports in Surgery.2016; 2016: 1. CrossRef

6,983 View
70 Download
10 Web of Science
8 Crossref

Percutaneous Cholangioscopic Lithotripsy for Afferent Loop Syndrome Caused by Enterolith Development after Roux-en-Y Hepaticojejunostomy: A Case Report: Seong Hyun Kim, Seok Jeong, Don Haeng Lee, Sung Soo Yoo, Keon-Young Lee; Clin Endosc 2013;46(6):679-682. Published online November 19, 2013; DOI: https://doi.org/10.5946/ce.2013.46.6.679

Abstract PDF PubReader ePub

Afferent loop obstruction caused by enterolith formation is rare and cannot be easily treated with endoscopy because of the difficulty associated with the nonsurgical removal of enteroliths. A 74-year-old woman was admitted with fever and acute abdominal pain. Clinical features and imaging studies suggested afferent loop obstruction caused by an enterolith after Roux-en-Y hepaticojejunostomy. Percutaneous transhepatic biliary drainage was initially performed because of severe cholangitis with septic shock. The enterolith was located in the jejunal limb adjacent to the hepaticojejunostomy site. Cholangioscopic lithotripsy was performed through the percutaneous transhepatic route to the enterolith, and the fragments were moved into the efferent loop using scope push and saline flush methods. Here, we describe a case of afferent loop syndrome caused by an enterolith that developed after Roux-en-Y hepaticojejunostomy and was treated with percutaneous transhepatic cholangio-enteroscopic lithotripsy.

Citations

Citations to this article as recorded by

Migrated Pancreaticojejunal Stent Forming a Stent–Stone Complex in the Jejunum with Resultant Small Bowel Obstruction: A Case Report
Jiwon Kim, Young Han Kim, Byung-Hee Lee
Journal of the Korean Society of Radiology.2023; 84(2): 512. CrossRef
Enterolith Causing Afferent Loop Perforation After Distal Gastrectomy
Naoya Ozawa, Masaki Kanzaki
Cureus.2023;[Epub] CrossRef
Successful treatment of postoperative nonobstructive recurrent cholangitis by tract conversion surgery after total pancreatectomy: a case report
Masanori Odaira, Fumiki Toriumi, Shota Hoshino, Nozomi Iwama, Yasuhiro Ito, Takashi Endo, Hirohisa Harada
Surgical Case Reports.2023;[Epub] CrossRef
Enterolith in Roux limb causing extrahepatic biliary obstruction in a patient with a hepaticojejunostomy: case report and relevant literature review
Vipan Kumar, Venu Bhargava Mulpuri, Pankaj Gupta, Vikas Gupta
BMJ Case Reports.2022; 15(3): e246935. CrossRef
Choledochoscopy: An update
Tsinrong Lee, Thomas Zheng Jie Teng, Vishal G Shelat
World Journal of Gastrointestinal Endoscopy.2021; 13(12): 571. CrossRef
Roux‐en‐Y enterolith leading to obstruction and ischemic necrosis after pediatric orthotopic liver transplantation
Ralph C. Quillin, Advaith Bongu, Vania Kasper, Jennifer M. Vittorio, Mercedes Martinez, Steven J. Lobritto, Adam D. Griesemer, James V. Guarrera
Pediatric Transplantation.2018;[Epub] CrossRef
Recurrent Cholangitis by Biliary Stasis Due to Non-Obstructive Afferent Loop Syndrome After Pylorus-Preserving Pancreatoduodenectomy: Report of a Case
Yukihiro Sanada, Naoya Yamada, Masanobu Taguchi, Kazue Morishima, Naoya Kasahara, Yuji Kaneda, Atsushi Miki, Yasunao Ishiguro, Akira Kurogochi, Kazuhiro Endo, Masaru Koizumi, Hideki Sasanuma, Takehito Fujiwara, Yasunaru Sakuma, Atsushi Shimizu, Masanobu H
International Surgery.2014; 99(4): 426. CrossRef

6,953 View
50 Download
7 Crossref

Endoscopic Management of Afferent Loop Syndrome after a Pylorus Preserving Pancreatoduodenecotomy Presenting with Obstructive Jaundice and Ascending Cholangitis: Jae Kyung Kim, Chan Hyuk Park, Ji Hye Huh, Jeong Youp Park, Seung Woo Park, Si Young Song, Jaebock Chung, Seungmin Bang; Clin Endosc 2011;44(1):59-64. Published online September 30, 2011; DOI: https://doi.org/10.5946/ce.2011.44.1.59

Abstract PDF PubReader ePub

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.

Citations

Citations to this article as recorded by

Percutaneous transhepatic duodenal drainage is good option for afferent loop syndrome for obstructive colorectal cancer patient with history of Billroth's operation II: A case report of a rare postoperative complication
Tung‐Yuan Chen, Chin‐Wen Hsu, Yee‐Phoung Chang, Min‐Tsung Wang, Yueh‐Jung Wu, Ching‐Hsien Wang, Kuan‐Yu Wang, Tian‐Huei Chu, Yung‐Kuo Lee
Clinical Case Reports.2023;[Epub] CrossRef
An Unusual Presentation of Obstructive Jaundice Due to Dilated Proximal Small Bowel Loops After Gastrojejunostomy: Afferent Loop Syndrome
Mahrukh Ali, Om Parkash, Jehanzeb Shahid
Cureus.2022;[Epub] CrossRef
The Use of Palliative Endoscopic Ultrasound-guided Enterostomy to Treat Small Bowel Obstruction in Two Patients with Advanced Malignancies
Ji Hong Oh, Seung Goun Hong
The Korean Journal of Medicine.2022; 97(3): 191. CrossRef
Endoscopic Transluminal Stent Placement for Malignant Afferent Loop Obstruction
Chinatsu Yonekura, Takashi Sasaki, Takafumi Mie, Takeshi Okamoto, Tsuyoshi Takeda, Takaaki Furukawa, Yuto Yamada, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira
Journal of Clinical Medicine.2022; 11(21): 6357. CrossRef
Clinical management for malignant afferent loop obstruction
Arata Sakai, Hideyuki Shiomi, Atsuhiro Masuda, Takashi Kobayashi, Yasutaka Yamada, Yuzo Kodama
World Journal of Gastrointestinal Oncology.2021; 13(7): 509. CrossRef
Clinical management for malignant afferent loop obstruction
Arata Sakai, Hideyuki Shiomi, Atsuhiro Masuda, Takashi Kobayashi, Yasutaka Yamada, Yuzo Kodama
World Journal of Gastrointestinal Oncology.2021; 13(7): 684. CrossRef
Endoscopic Self-Expandable Metal Stent Placement for Malignant Afferent Loop Obstruction After Pancreaticoduodenectomy: A Case Series and Review
Arata Sakai, Hideyuki Shiomi, Takao Iemoto, Ryota Nakano, Takuya Ikegawa, Takashi Kobayashi, Atsuhiro Masuda, Yuzo Kodama
Clinical Endoscopy.2020; 53(4): 491. CrossRef
Endoscopic nasogastric tube insertion for treatment of benign afferent loop obstruction after radical gastrectomy for gastric cancer
Yuning Cao, Xiangheng Kong, Daogui Yang, Senlin Li
Medicine.2019; 98(28): e16475. CrossRef
Comparative analysis of afferent loop obstruction between laparoscopic and open approach in pancreaticoduodenectomy
Ki Byung Song, Daegwang Yoo, Dae Wook Hwang, Jae Hoon Lee, Jaewoo Kwon, Sarang Hong, Jong Woo Lee, Woo Young Youn, Kyungyeon Hwang, Song Cheol Kim
Journal of Hepato-Biliary-Pancreatic Sciences.2019; 26(10): 459. CrossRef
Metal Stent Placement in the Afferent Loop Obstructed by Peritoneal Metastases—Experience of Five Cases
Yoshihide Kanno, Tetsuya Ohira, Yoshihiro Harada, Yoshiki Koike, Taku Yamagata, Megumi Tanaka, Tomohiro Shimada, Kei Ito
Clinical Endoscopy.2018; 51(3): 299. CrossRef
Colangitis por obstrucción de asa aferente tras duodenopancreatectomía cefálica
José Ruiz Pardo, Erik Llàcer-Millán, Pilar Jimeno Griñó, Juan Ángel Fernández Hernández, Pascual Parrilla Paricio
Cirugía Española.2016; 94(2): 106. CrossRef
Cholangitis Due to Afferent Loop Obstruction After Cephalic Duodenopancreatectomy
José Ruiz Pardo, Erik Llàcer-Millán, Pilar Jimeno Griñó, Juan Ángel Fernández Hernández, Pascual Parrilla Paricio
Cirugía Española (English Edition).2016; 94(2): 106. CrossRef
An unusual cause of simultaneous common bile and pancreatic duct dilation
Puneet Chhabra, Surinder Singh Rana, Vishal Sharma, Ravi Sharma, Rajesh Gupta, Deepak Kumar Bhasin
Gastroenterology Report.2015; 3(3): 258. CrossRef
A Case of Afferent Loop Syndrome Treated by Endoscopic Metal Stent Insertion Using Two Endoscopes
Jun Jae Kim, Young Koog Cheon, Tae Yoon Lee, Chan Sup Shim
The Korean Journal of Medicine.2015; 89(4): 428. CrossRef
Acute afferent loop syndrome in the early postoperative period following pancreaticoduodenectomy
H Nageswaran, A Belgaumkar, R Kumar, A Riga, N Menezes, T Worthington, ND Karanjia
The Annals of The Royal College of Surgeons of England.2015; 97(5): 349. CrossRef
Recurrent Cholangitis by Biliary Stasis Due to Non-Obstructive Afferent Loop Syndrome After Pylorus-Preserving Pancreatoduodenectomy: Report of a Case
Yukihiro Sanada, Naoya Yamada, Masanobu Taguchi, Kazue Morishima, Naoya Kasahara, Yuji Kaneda, Atsushi Miki, Yasunao Ishiguro, Akira Kurogochi, Kazuhiro Endo, Masaru Koizumi, Hideki Sasanuma, Takehito Fujiwara, Yasunaru Sakuma, Atsushi Shimizu, Masanobu H
International Surgery.2014; 99(4): 426. CrossRef
A Case of Gastrojejunostomy under Endoscopic Ultrasound Guidance for the Treatment of Jejunal Stenosis Induced by Cholangiocarcinoma Recurrence after Pancreaticoduodenectomy
Chikashi WATASE, Junzo SHIMIZU, Masahiro MURAKAMI, Yong Kong KIM, Shoki MIKATA, Junichi HASEGAWA
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2014; 75(8): 2307. CrossRef
Electrohydraulic Lithotripsy of an Impacted Enterolith Causing Acute Afferent Loop Syndrome
Young Sin Cho, Tae Hoon Lee, Soon Oh Hwang, Sunhyo Lee, Yunho Jung, Il-Kwun Chung, Sang-Heum Park, Sun-Joo Kim
Clinical Endoscopy.2014; 47(4): 367. CrossRef

7,765 View
62 Download
18 Crossref

A Bezoar That Caused Afferent Loop Syndrome and Pancreatitis: Hyuk Soon Choi, M.D., Chang Duck Kim, M.D., Hyun Seok Kang, M.D., Seok Bae Yoon, M.D., Yoon Tae Jeen, M.D., Hoon Jai Chun, M.D., Soon Ho Um, M.D. and Ho Sang Ryu, M.D.; Korean J Gastrointest Endosc 2009;39(5):291-295. Published online November 30, 2009

Abstract PDF: Bezoars are conglomerates of nondigestible matter in the gastrointestinal tract that may or may not be accompanied by gastrointestinal manifestations. Bezoars develop in patients with previous gastric surgery or in those patients with delayed gastric emptying that is due to gastroparesis caused by hypothyroidism or diabetes mellitus. Small bowel obstruction due to a gastric bezoar is rare, but it can lead to severe complications such as intestinal perforation, compression necrosis etc. A female patient came to our department complaining of upper abdominal pain and she was diagnosed as having a bezoar that was causing afferent loop syndrome and pancreatitis. We attempted to manage the patient by inserting a nasogastric tube, performing gastrofibroscopy and implementing percutaneous transhepatic biliary drainage, but the patient's condition worsened and deteriorated into a septic condition. An operation was planned, but the patient showed improvement owing to the migration of the bezoar. Herein, we report on a case of afferent loop syndrome due to bezoar and this was complicated by acute pancreatitis. (Korean J Gastrointest Endosc 2009;39:291-295)

2,173 View
14 Download

A Case of Afferent Loop Syndrome after Inserting a Double-Layered Pyloric Stent for Gastric Outlet Obstruction in a Patient with Stump Gastric Cancer after Undergoing Billroth II Radical Subtotal Gastrectomy: Seok Lee, M.D., Yu Jeong Hwang, M.D., Seong Hun Kim, M.D., In Hee Kim, M.D., Sang Wook Kim, M.D., Seung Ok Lee, M.D., Dae Ghon Kim, M.D. and Soo Teik Lee, M.D.; Korean J Gastrointest Endosc 2009;38(3):147-150. Published online March 30, 2009

Abstract PDF: Stent insertion is an effective method for treating a patient with gastric outlet obstruction that's caused by recurred cancer at the anastomosis site. There are some complications associated with stent insertion, such as perforation, bleeding, ulceration and obstruction. There are only rare Korean case reports of afferent loop syndrome after stent insertion. We report here on a case of afferent loop syndrome that occurred after insertion of a double-layered pyloric stent for gastric outlet obstruction in a patient with stump gastric cancer after undergoing Billroth II radical subtotal gastrectomy.(Korean J Gastrointest Endosc 2009;38:147-150)

1,865 View
11 Download

First
Prev
Page of 1
Next
Last

Search