Cholangitis Due to Afferent Loop Obstruction After Cephalic Duodenopancreatectomy

Llàcer-Millán, Erik; Griñó, P; Hernández, Juan Ángel Fernández; Paricio, Pascual Parrilla

doi:10.1016/j.cireng.2015.08.004

Cited by 1 publication

(2 citation statements)

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“…3,4 Likewise, enterobiliary reflux from the obstructed bowel loop can cause biliary dilatation and acute ascending cholangitis complicated by sepsis and bacteremia as a consequence of bacterial translocation into the systemic circulation. 5,6 Therefore, ALS requires appropriate early decompression treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, increased intraluminal pressure in the afferent loop can cause dilatation of the duct of Wirsung, which in turn triggers an inflammatory response, resulting in acute pancreatitis 3,4 . Likewise, enterobiliary reflux from the obstructed bowel loop can cause biliary dilatation and acute ascending cholangitis complicated by sepsis and bacteremia as a consequence of bacterial translocation into the systemic circulation 5,6 . Therefore, ALS requires appropriate early decompression treatment.…”

Section: Introductionmentioning

confidence: 99%

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Early and late effects of endoscopic interventions in patients with malignant afferent loop syndrome: A single‐center experience and literature review

Yamamoto,

Itoi,

Matsunami

et al. 2023

J Hepato Biliary Pancreat

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Background/PurposeAfferent loop syndrome (ALS) is a rare adverse event after gastrointestinal surgery requiring appropriate early decompression treatment. Several endoscopic interventions have been attempted for treatment, including endoscopic enteral metal stent placement (EMSP), endoscopic ultrasound (EUS)‐guided entero‐enterostomy (EUS‐EE), and EUS‐guided hepaticogastrostomy (EUS‐HGS). However, there are limited data on outcomes, including duration of stent patency. In this study, we evaluated the usefulness of each endoscopic intervention for malignant ALS.MethodsWe retrospectively investigated nine patients with malignant ALS who underwent EMSP, EUS‐EE, or EUS‐HGS. Information on technical success, clinical efficacy, adverse events, stent dysfunction, and overall survival was collected and analyzed.ResultsThe most common symptoms were abdominal pain and cholangitis. ALS was treated by EMSP in three patients, EUS‐EE in three patients, and EUS‐HGS in three patients. Stent placement was successful and clinically effective in all patients with no adverse events. During follow‐up, stent dysfunction occurred in two patients treated by EUS‐HGS. Eight patients died of primary disease during a median follow‐up of 157 days.ConclusionsEach of the available endoscopic interventions for malignant ALS can be expected to produce similar outcomes, including duration of stent patency. The choice of endoscopic intervention should be made based on the characteristics of each treatment.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%