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

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)59-64
Number of pages6
JournalClinical Endoscopy
Volume44
Issue number1
DOIs
StatePublished - Dec 1 2011

Fingerprint

Afferent Loop Syndrome
Cholangitis
Obstructive Jaundice
Pylorus
Pancreaticoduodenectomy
Gastric Bypass
Endoscopes
Pancreatic Neoplasms
Vomiting
Stents
Metals
Recurrence

Keywords

  • Afferent loop syndrome
  • Endoscopic treatment
  • Obstructive jaundice
  • Pylorus preserving pancreaticoduodenectomy

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Endoscopic management of afferent loop syndrome after a pylorus preserving pancreatoduodenecotomy presenting with obstructive jaundice and ascending cholangitis. / Kim, Jae Kyung; Park, Chan Hyuk; Huh, Ji Hye; Park, Jeong Youp; Park, Seung Woo; Song, Si Young; Chung, Jaebock; Bang, Seungmin.

In: Clinical Endoscopy, Vol. 44, No. 1, 01.12.2011, p. 59-64.

Research output: Contribution to journalArticle

Kim, Jae Kyung ; Park, Chan Hyuk ; Huh, Ji Hye ; Park, Jeong Youp ; Park, Seung Woo ; Song, Si Young ; Chung, Jaebock ; Bang, Seungmin. / Endoscopic management of afferent loop syndrome after a pylorus preserving pancreatoduodenecotomy presenting with obstructive jaundice and ascending cholangitis. In: Clinical Endoscopy. 2011 ; Vol. 44, No. 1. pp. 59-64.
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