Skip to main content
Top
Published in: Clinical Journal of Gastroenterology 2/2015

01-04-2015 | Case Report

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

Authors: Arata Sakai, Hideyuki Shiomi, Yoshihiro Okabe, Yousuke Yagi, Takashi Kobayashi, Yuuki Shiomi, Mamoru Takenaka, Namiko Hoshi, Yoshifumi Arisaka, Hiromu Kutsumi, Takeshi Azuma

Published in: Clinical Journal of Gastroenterology | Issue 2/2015

Login to get access

Abstract

Afferent loop obstruction caused by cancer recurrence after pancreaticoduodenectomy (PD) can be managed by either surgical or nonsurgical treatment. The general condition of patients with recurrent pancreaticobiliary cancer is often not good enough for them to undergo surgery, so less invasive nonsurgical treatment is desirable. We report a case of a 66-year-old male who had undergone PD for pancreatic head adenocarcinoma 10 months previously and who presented at our hospital with fever and jaundice due to afferent loop obstruction caused by pancreatic cancer recurrence. An endoscopic self-expandable metal stent (SEMS) was placed for afferent loop obstruction without any complications. He quickly recovered after SEMS placement. He retained a good quality of life by receiving chemotherapy until his death due to cancer progression. Our case indicates that this method could be an easy, effective, safe, and less invasive treatment, which may confer a better quality of life for patients with afferent loop obstruction due to cancer recurrence after PD.
Literature
2.
go back to reference Matsuno S, Egawa S, Fukuyama S, et al. Pancreatic cancer registry in Japan: 20 years of experience. Pancreas. 2004;28:219–30.CrossRefPubMed Matsuno S, Egawa S, Fukuyama S, et al. Pancreatic cancer registry in Japan: 20 years of experience. Pancreas. 2004;28:219–30.CrossRefPubMed
3.
go back to reference Hirata K, Egawa S, Kimura Y, et al. Current status of surgery for pancreatic cancer. Dig Surg. 2007;24:137–47.CrossRefPubMed Hirata K, Egawa S, Kimura Y, et al. Current status of surgery for pancreatic cancer. Dig Surg. 2007;24:137–47.CrossRefPubMed
4.
go back to reference Ueno H, Kosuge T, Matsuyama Y, et al. A randomised phase III trial comparing gemcitabine with surgery-only in patients with resected pancreatic cancer: Japanese Study Group of Adjuvant Therapy for Pancreatic Cancer. Br J Cancer. 2009;101:908–15.CrossRefPubMedCentralPubMed Ueno H, Kosuge T, Matsuyama Y, et al. A randomised phase III trial comparing gemcitabine with surgery-only in patients with resected pancreatic cancer: Japanese Study Group of Adjuvant Therapy for Pancreatic Cancer. Br J Cancer. 2009;101:908–15.CrossRefPubMedCentralPubMed
5.
go back to reference Chevallier P, Novellas S, Motamedi JP, et al. Percutaneous jejunostomy and stent placement for treatment of malignant Roux-en-Y obstruction: a case report. Clin Imaging. 2006;30:283–6.CrossRefPubMed Chevallier P, Novellas S, Motamedi JP, et al. Percutaneous jejunostomy and stent placement for treatment of malignant Roux-en-Y obstruction: a case report. Clin Imaging. 2006;30:283–6.CrossRefPubMed
6.
go back to reference Aimoto T, Uchida E, Nakamura Y, et al. Malignant afferent loop obstruction following pancreatoduodenectomy: report of two cases. J Nippon Med Sch. 2006;73:226–30.CrossRefPubMed Aimoto T, Uchida E, Nakamura Y, et al. Malignant afferent loop obstruction following pancreatoduodenectomy: report of two cases. J Nippon Med Sch. 2006;73:226–30.CrossRefPubMed
7.
go back to reference Pannala R, Brandabur JJ, Gan S, et al. Afferent limb syndrome and delayed GI problems after pancreaticoduodenectomy for pancreatic cancer: single-center, 14-year experience. Gastrointest Endosc. 2011;74:295–302.CrossRefPubMed Pannala R, Brandabur JJ, Gan S, et al. Afferent limb syndrome and delayed GI problems after pancreaticoduodenectomy for pancreatic cancer: single-center, 14-year experience. Gastrointest Endosc. 2011;74:295–302.CrossRefPubMed
8.
go back to reference Beger HG, Treitschke F, Gansauge F, et al. Tumor of the ampulla of Vater: experience with local or radical resection in 171 consecutively treated patients. Arch Surg. 1999;134:526–32.CrossRefPubMed Beger HG, Treitschke F, Gansauge F, et al. Tumor of the ampulla of Vater: experience with local or radical resection in 171 consecutively treated patients. Arch Surg. 1999;134:526–32.CrossRefPubMed
9.
go back to reference Morita S, Takemura T, Matsumoto S, et al. Septic shock after percutaneous transhepatic drainage of obstructive afferent loop: case report. Cardiovasc Intervent Radiol. 1989;12:66–8.CrossRefPubMed Morita S, Takemura T, Matsumoto S, et al. Septic shock after percutaneous transhepatic drainage of obstructive afferent loop: case report. Cardiovasc Intervent Radiol. 1989;12:66–8.CrossRefPubMed
10.
go back to reference Yao NS, Wu CW, Tiu CM. Percutaneous transhepatic duodenal drainage as an alternative approach in afferent loop obstruction with secondary obstructive jaundice in recurrent gastric cancer. Cardiovasc Intervent Radiol. 1998;21:350–3.CrossRefPubMed Yao NS, Wu CW, Tiu CM. Percutaneous transhepatic duodenal drainage as an alternative approach in afferent loop obstruction with secondary obstructive jaundice in recurrent gastric cancer. Cardiovasc Intervent Radiol. 1998;21:350–3.CrossRefPubMed
11.
go back to reference Caldicott DG, Ziprin P, Morgan R. Transhepatic insertion of a metallic stent for the relief of malignant afferent loop obstruction. Cardiovasc Intervent Radiol. 2000;23:138–51.CrossRefPubMed Caldicott DG, Ziprin P, Morgan R. Transhepatic insertion of a metallic stent for the relief of malignant afferent loop obstruction. Cardiovasc Intervent Radiol. 2000;23:138–51.CrossRefPubMed
12.
go back to reference Hosokawa I, Kato A, Shimizu H, et al. Percutaneous transhepatic metallic stent insertion for malignant afferent loop obstruction following pancreaticoduodenectomy: a case report. J Med Case Rep. 2012;6:198.CrossRefPubMedCentralPubMed Hosokawa I, Kato A, Shimizu H, et al. Percutaneous transhepatic metallic stent insertion for malignant afferent loop obstruction following pancreaticoduodenectomy: a case report. J Med Case Rep. 2012;6:198.CrossRefPubMedCentralPubMed
13.
go back to reference Espinel J, Sanz O, Vivas S, et al. Malignant gastrointestinal obstruction: endoscopic stenting versus surgical palliation. Surg Endosc. 2006;20:1083–7.CrossRefPubMed Espinel J, Sanz O, Vivas S, et al. Malignant gastrointestinal obstruction: endoscopic stenting versus surgical palliation. Surg Endosc. 2006;20:1083–7.CrossRefPubMed
14.
go back to reference Burdick JS, Garza AA, Magee DJ, et al. Endoscopic management of afferent loop syndrome of malignant etiology. Gastrointest Endosc. 2002;55:602–5.CrossRefPubMed Burdick JS, Garza AA, Magee DJ, et al. Endoscopic management of afferent loop syndrome of malignant etiology. Gastrointest Endosc. 2002;55:602–5.CrossRefPubMed
15.
go back to reference Sasaki T, Isayama H, Kogure H, et al. Double-balloon enteroscope-assisted enteral stent placement for malignant afferent-loop obstruction after Roux-en-Y reconstruction. Endoscopy. 2014;46:E541–2.CrossRefPubMed Sasaki T, Isayama H, Kogure H, et al. Double-balloon enteroscope-assisted enteral stent placement for malignant afferent-loop obstruction after Roux-en-Y reconstruction. Endoscopy. 2014;46:E541–2.CrossRefPubMed
16.
go back to reference Lee H, Park JC, Shin SK, et al. Preliminary study of enteroscopy-guided, self-expandable metal stent placement for malignant small bowel obstruction. J Gastroenterol Hepatol. 2012;27:1181–6.CrossRefPubMed Lee H, Park JC, Shin SK, et al. Preliminary study of enteroscopy-guided, self-expandable metal stent placement for malignant small bowel obstruction. J Gastroenterol Hepatol. 2012;27:1181–6.CrossRefPubMed
Metadata
Title
Effectiveness of endoscopic self-expandable metal stent placement for afferent loop obstruction caused by pancreatic cancer recurrence after pancreaticoduodenectomy
Authors
Arata Sakai
Hideyuki Shiomi
Yoshihiro Okabe
Yousuke Yagi
Takashi Kobayashi
Yuuki Shiomi
Mamoru Takenaka
Namiko Hoshi
Yoshifumi Arisaka
Hiromu Kutsumi
Takeshi Azuma
Publication date
01-04-2015
Publisher
Springer Japan
Published in
Clinical Journal of Gastroenterology / Issue 2/2015
Print ISSN: 1865-7257
Electronic ISSN: 1865-7265
DOI
https://doi.org/10.1007/s12328-015-0556-0

Other articles of this Issue 2/2015

Clinical Journal of Gastroenterology 2/2015 Go to the issue