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The Role of Endoscopic Management in Afferent Loop Syndrome

Wu Clement Chun Ho|Brindise Elizabeth|Abiad Rami El|Khashab Mouen A.
거트앤리버 소화기연관학회협의회|2023.05|Gut and Liver|제17권 제3호|pp. 351-359|DOI 10.5009/gnl220205

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키워드

Endoscopic ultrasonographyGastrojejunostomyEnterostomyAfferent loop syndromeSelf expandable metal stent

초록

Afferent loop syndrome (ALS) is a morbid complication that may occur after gastrectomy and gastrojejunostomy reconstruction. The aim of this article is to review the different endoscopic treatment options of ALS. We describe the evolution of the endoscopic treatment of ALS and its limitations despite the overall propitious profile. We analyze the advantages of endoscopic ultrasound-guided entero-enterostomy (EUS EE) over enteroscopy-guided intervention, and the clinical outcomes of EUS EE. We expound on pre-procedural considerations, intra-procedural techniques and post-procedural care following EUS EE. We conclude that given the simplification of the technique and the ability to place a stent away from the tumor, EUS EE is a promising technique that will likely be established as the treatment of choice for ALS.

Abstract

Afferent loop syndrome (ALS) is a morbid complication that may occur after gastrectomy and gastrojejunostomy reconstruction. The aim of this article is to review the different endoscopic treatment options of ALS. We describe the evolution of the endoscopic treatment of ALS and its limitations despite the overall propitious profile. We analyze the advantages of endoscopic ultrasound-guided entero-enterostomy (EUS EE) over enteroscopy-guided intervention, and the clinical outcomes of EUS EE. We expound on pre-procedural considerations, intra-procedural techniques and post-procedural care following EUS EE. We conclude that given the simplification of the technique and the ability to place a stent away from the tumor, EUS EE is a promising technique that will likely be established as the treatment of choice for ALS.

참고문헌 (49)

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Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop SyndromeArata Sakai, Atsuhiro Masuda, Hideyuki Shiomi, Hiroko Iijima, Ryota Nakano, Shogo Ota, Takashi Kobayashi대한소화기내시경학회 · Clinical Endoscopy2021 · 제54권 제6호Recent developments in endoscopic ultrasonography-guided gastroenterostomyKenjiro Yamamoto, Takao Itoi소화기인터벤션의학회 · International Journal of Gastrointestinal Intervention2020 · 제9권 제4호Endoscopic Management of Afferent Loop Syndrome after a Pylorus Preserving Pancreatoduodenecotomy Presenting with Obstructive Jaundice and Ascending Cholangitis김재경, 박승우, 박정엽, 박찬혁, 방승민, 송시영, 정재복, 허지혜대한소화기내시경학회 · Clinical Endoscopy2011 · 제44권 제1호Metal Stent Placement in the Afferent Loop Obstructed by Peritoneal Metastases—Experience of Five CasesKei Ito, Megumi Tanaka, Taku Yamagata, Tetsuya Ohira, Tomohiro Shimada, Yoshihide Kanno, Yoshihiro Harada, Yoshiki Koike대한소화기내시경학회 · Clinical Endoscopy2018 · 제51권 제3호Percutaneous metallic stent placement for malignant afferent loop syndrome via the blind end of the jejunal limb after biliary reconstructionKazuo Hara, Shinichi Murata, Shohei Chatani, Takaaki Hasegawa, Takamichi Kuwahara, Yasuhiro Shimizu, Yoshitaka Inaba, Yozo Sato소화기인터벤션의학회 · International Journal of Gastrointestinal Intervention2021 · 제10권 제1호Endoscopic Self-Expandable Metal Stent Placement for Malignant Afferent Loop Obstruction After Pancreaticoduodenectomy: A Case Series and ReviewArata Sakai, Atsuhiro Masuda, Hideyuki Shiomi, Ryota Nakano, Takao Iemoto, Takashi Kobayashi, Takuya Ikegawa, Yuzo Kodama대한소화기내시경학회 · Clinical Endoscopy2020 · 제53권 제4호

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