Afferent limb syndrome and delayed GI problems after pancreaticoduodenectomy for pancreatic cancer: single-center, 14-year experience

Effectiveness of endoscopic self-expandable metal stent placement for afferent loop obstruction caused by pancreatic cancer recurrence after pancreaticoduodenectomy

“…Afferent loop obstruction after PD often leads to the development of cholangitis or jaundice because of the loss of papillary function, which tend to lead to life-threatening conditions in post-PD patients, so immediate and effective treatment is required. In a series of 186 pancreatic carcinoma patients treated with PD and followed for a median duration of 1.2 years, Pannala et al [7] reported afferent loop obstruction in 24 patients (13 %), of whom 8 were due to cancer recurrence (33 %). This suggests that afferent loop obstruction is relatively common in pancreatic cancer patients after PD.…”

“…Afferent loop obstruction after PD is usually managed by surgical or nonsurgical treatment [5][6][7][8][9][10][11][12]. Surgery is effective but invasive.…”

Afferent Loop Syndrome

“…He found that 0.2 % of these patients developed ALS. Pannala reported that the incidence of ALS in a cohort of 186 pancreatic cancer patients after pancreaticoduodenectomy was as high as 13 % [7]. Kim retrospectively reviewed a surgical database of 396 patients who underwent laparoscopic distal gastrectomy with Billroth II reconstruction between 2004 and 2011 and found an incidence of ALS of 1.01 % [8].…”

Percutaneous Drainage for Afferent Limb Syndrome and Pancreatic Fistula via the Blind End of the Jejunal Limb after Pancreatoduodenectomy or Bile Duct Resection

“…Postoperative or delayed complications can occur after pancreatoduodenectomy (PD) or bile duct resection with reconstruction (3)(4)(5). Occasionally, it is difficult to treat these conditions because of the occurrence of complicated anatomic changes after operative reconstruction.…”

“…The reported incidence rates of pancreatic fistula and bile leakage range from 5%-25% and 0.4%-8%, respectively (3,4,7). Afferent limb syndrome was defined as mechanical obstruction of the afferent limb resulting in pancreatobiliary problems (5). The reported incidence of afferent limb syndrome after PD for pancreatic cancer in a single-center experience (5) was 13%, with the incidence of malignant afferent limb obstruction secondary to recurrence being 33% in these patients.…”