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Case Reports
. 2022 Jul 29;3(1):e156.
doi: 10.1002/deo2.156. eCollection 2023 Apr.

Treatment of efferent loop syndrome after pancreatoduodenectomy with a fully covered self-expandable metal stent: A case report

Jun Wu  1 , Cui Chen  1 , Bing Hu  1
Affiliations
Case Reports

Treatment of efferent loop syndrome after pancreatoduodenectomy with a fully covered self-expandable metal stent: A case report

Jun Wu et al. DEN Open. .

Abstract

Efferent loop syndrome is a very rare complication following pancreatoduodenectomy. The treatment of efferent loop syndrome varies depending on the cause of the syndrome. Conservative treatment methods, including nasogastric drainage and enteral nutrition, are adopted that are effective in most of patients; however, surgical treatment is usually required in patients with complete loop obstruction. Herein, we report a case of severe efferent loop obstruction that occurred after pancreatoduodenectomy, which was refractory to conservative treatment and successfully resolved by insertion of a fully covered self-expandable metal stent.

Keywords: case report; efferent loop syndrome; endoscopic treatment; metal stent; pancreatoduodenectomy.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
The first endoscopic intervention process. (a) Gastroscopy showed anastomotic stoma is severely edematous. (b) The intestine of efferent loop was narrow and edematous. (c) Enterography showed stenosis of efferent loop approximately 3 cm below the site of anastomosis. (d) A three‐lumen gastrojejunal tube was placed across the anastomosis and intestinal stricture
FIGURE 2
FIGURE 2
The second endoscopic intervention process. (a) Gastroscopy showed anastomotic edema was significantly relieved. (b) The intestine of efferent loop was still narrow. (c) Endoscopic pneumatic balloon dilatation is shown, and thick yellow arrow indicated the stenosis area. (d) A fully covered metal stent was inserted through the stenosis of efferent loop and over the guide wire under fluoroscopy
FIGURE 3
FIGURE 3
The third endoscopic intervention process. (a) Abdominal fluoroscopy showed that the stent was in good position and the stricture was relieved at 1 month after stent insertion. (b) The stent was completely displaced into the gastric cavity, thick yellow arrow indicated the orifice of afferent loop, and thin yellow arrow indicated the orifice of efferent loop. (c) The stenosis of efferent loop was significantly relieved
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References

    1. Diener MK, Knaebel HP, Heukaufer C et al. A systematic review and meta‐analysis of pylorus‐preserving versus classical pancreaticoduodenectomy for surgical treatment of periampullary and pancreatic carcinoma. Ann Surg 2007; 245: 187–200. - PMC - PubMed
    1. Pedrazzani C, Marrelli D, Rampone B et al. Postoperative complications and functional results after subtotal gastrectomy with Billroth II reconstruction for primary gastric cancer. Dig Dis Sci 2007; 52: 1757–63. - PubMed
    1. Tharavej C, Kattipatanapong W, Pungpapong S et al. Outcome of endoscopic small‐bore naso‐jejunal tube stenting in early postoperative jejunal limb obstruction after gastrectomy. Surg Endosc 2019; 33: 520–7. - PubMed
    1. Shchepotin IB, Evans SR, Chorny VA, Shabahang M, Buras RR, Nauta RJ. Postoperative complications requiring relaparotomies after 700 gastretomies performed for gastric cancer. Am J Surg 1996; 171: 270–3. - PubMed
    1. Storm AC, Ryou M. Advances in the endoscopic management of gastric outflow disorders. Curr Opin Gastroenterol 2017; 33: 455–60. - PubMed

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