Clinical Endoscopy

  • 제44권1호
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  • Pages.59-64
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  • 2011
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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Endoscopic Management of Afferent Loop Syndrome after a Pylorus Preserving Pancreatoduodenecotomy Presenting with Obstructive Jaundice and Ascending Cholangitis

  • Kim, Jae-Kyung (Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine) ;
  • Park, Chan-Hyuk (Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine) ;
  • Huh, Ji-Hye (Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine) ;
  • Park, Jeong-Youp (Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine) ;
  • Park, Seung-Woo (Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine) ;
  • Song, Si-Young (Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine) ;
  • Chung, Jae-Bock (Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine) ;
  • Bang, Seung-Min (Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine)
  • 발행 : 2011.09.30
⟨ 이전 논문 다음 논문 ⟩

초록

Afferent loop syndrome is a rare complication of gastrojejunostomy. Patients usually present with abdominal distention and bilious vomiting. 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.

키워드

참고문헌

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피인용 문헌

  1. Electrohydraulic Lithotripsy of an Impacted Enterolith Causing Acute Afferent Loop Syndrome vol.47, pp.4, 2011, https://doi.org/10.5946/ce.2014.47.4.367
  2. A Case of Gastrojejunostomy under Endoscopic Ultrasound Guidance for the Treatment of Jejunal Stenosis Induced by Cholangiocarcinoma Recurrence after Pancreaticoduodenectomy vol.75, pp.8, 2014, https://doi.org/10.3919/jjsa.75.2307
  3. Acute afferent loop syndrome in the early postoperative period following pancreaticoduodenectomy vol.97, pp.5, 2015, https://doi.org/10.1308/003588414x14055925061036
  4. Endoscopic metal enteral stent placement for malignant afferent loop syndrome after pancreaticoduodenectomy vol.10, pp.2, 2015, https://doi.org/10.5114/wiitm.2015.51867
  5. An unusual cause of simultaneous common bile and pancreatic duct dilation vol.3, pp.3, 2015, https://doi.org/10.1093/gastro/gou032
  6. A Case of Afferent Loop Syndrome Treated by Endoscopic Metal Stent Insertion Using Two Endoscopes vol.89, pp.4, 2011, https://doi.org/10.3904/kjm.2015.89.4.428
  7. Cholangitis Due to Afferent Loop Obstruction After Cephalic Duodenopancreatectomy vol.94, pp.2, 2011, https://doi.org/10.1016/j.cireng.2015.08.004
  8. Metal Stent Placement in the Afferent Loop Obstructed by Peritoneal Metastases—Experience of Five Cases vol.51, pp.3, 2018, https://doi.org/10.5946/ce.2018.005
  9. Comparative analysis of afferent loop obstruction between laparoscopic and open approach in pancreaticoduodenectomy vol.26, pp.10, 2011, https://doi.org/10.1002/jhbp.656
  10. Endoscopic Self-Expandable Metal Stent Placement for Malignant Afferent Loop Obstruction After Pancreaticoduodenectomy: A Case Series and Review vol.53, pp.4, 2020, https://doi.org/10.5946/ce.2019.145
  11. Clinical management for malignant afferent loop obstruction vol.13, pp.7, 2011, https://doi.org/10.4251/wjgo.v13.i7.509