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Endoscopic management of afferent loop syndrome after a pylorus preserving pancreatoduodenecotomy presenting with obstructive jaundice and ascending cholangitis

 Jae Kyung Kim  ;  Chan Hyuk Park  ;  Jeong Youp Park  ;  Ji Hye Huh 
 Clinical Endoscopy, Vol.44(1) : 59-64, 2011 
Journal Title
 Clinical Endoscopy 
Issue Date
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.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김재경(Kim, Jae Kyoung) ; 박승우(Park, Seung Woo) ; 박정엽(Park, Jeong Youp) ; 박찬혁(Park, Chan Hyuk) ; 방승민(Bang, Seung Min) ; 송시영(Song, Si Young) ; 정재복(Chung, Jae Bock) ; 허지혜(Huh, Ji Hye)
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