• Journal of Gastric Cancer
• /
• v.4 no.3
• /
• pp.176-179
• /
• 2004

Surgical treatment for afferent loop syndrome (ALS) in patients with recurrent gastric cancer is usually not feasible because of the recurrent tumor mass at the anastomosis site and/or extensive carcinomatosis resulting in bowel loop fixation. Furthermore, ALS usually makes oral intake impossible, resulting in a rapid deterioration in general condition. In this situation, gastroscopic stenting at the anastomotic site and/or percutaneous external drainage may be a more feasible alternative for palliation. We herein report a recurrent gastric cancer whose ALS was successfully treated with internal and external drainage procedures.

• Journal of the Korean Society of Radiology
• /
• v.85 no.3
• /
• pp.661-667
• /
• 2024

Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

• The Journal of Internal Korean Medicine
• /
• v.25 no.3
• /
• pp.596-601
• /
• 2004

After a gastrectomy, various forms of postgastrectomy syndrome may happen, such as dumping syndrome, reflux $^{\wedge}esophagitis$, afferent loop syndrome, marginal ulcer, anemia, etc. These can cause some problems in the quality of life for post-gastrectomy patients. This oriental medicine treatment was designed to improve digestion and relieve symptoms, correct imbalance and prevent relapse in each case. This study suggests a level of efficacy of oriental medicine(Samryungbaekchul-san, Bobi-tang) in treating postgastrectomy syndrome.

• Journal of Digestive Cancer Research
• /
• v.11 no.2
• /
• pp.66-76
• /
• 2023

Endoscopy is an important noninvasive procedure for patients with gastrointestinal problems. However, surgical techniques are shifting to laparoscopic surgery, and changes in endoscopic findings after laparoscopic surgery differ from those after previous surgical methods. Postoperative endoscopic findings differ from normal anatomical structures, and findings reportedly vary depending on the type of surgical technique. Therefore, we aimed to summarize the surgical and endoscopic findings for each surgical method from the surgeon's point of view. The causes of gastric emptying delay, bleeding, afferent loop syndrome, or anastomosis leakage occurring after gastric cancer surgery can be identified via upper gastrointestinal endoscopy that is relatively less invasive than the surgical method. Regarding postoperative anastomosis leakage, endoscopy can directly evaluate the degree of leakage at the anastomosis site more accurately than computed tomography and enable immediate intervention. As endoscopy is less invasive than the surgical method, patients can be evaluated and treated more safely. However, coordination between the surgeon and the endoscopist is necessary to perform the procedures effectively. Therefore, reviewing the changes in surgical and endoscopic findings is important.