Open AccessMetallic stent insertion with double-balloon endoscopy for malignant afferent loop obstruction
Author(s) -
Masazumi Fujii,
Shuhei Ishiyama,
Hiroaki Saito,
Mamoru Ito,
Akiko Fujiwara,
Takefumi Niguma,
Masao Yoshioka,
Junji Shiode
Publication year - 2015
Publication title -
world journal of gastrointestinal endoscopy
Language(s) - English
Resource type - Journals
ISSN - 1948-5190
DOI - 10.4253/wjge.v7.i6.665
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , stent , surgery , percutaneous , nausea , vomiting , endoscopy , abdominal pain , balloon , radiology , pancreatitis
Progress in double-balloon endoscopy (DBE) has allowed for the diagnosis and treatment of disease in the postoperative bowel. For example, a short DBE, which has a 2.8 mm working channel and 152 cm working length, is useful for endoscopic retrograde cholangiopancreatography in bowel disease patients. However, afferent loop and Roux-limb obstruction, though rare, is caused by postoperative recurrence of biliary tract cancer with intractable complications. Most of the clinical findings involving these complications are relatively nonspecific and include abdominal pain, nausea, vomiting, fever, and obstructive jaundice. Treatments by surgery, percutaneous transhepatic biliary drainage, percutaneous enteral stent insertion, and endoscopic therapy have been reported. The general conditions of patients with these complications are poor due to cancer progression; therefore, a less invasive treatment is better. We report on the usefulness of metallic stent insertion using an overtube for afferent loop and Roux-limb obstruction caused by postoperative recurrence of biliary tract cancer under short DBE in two patients with complexly reconstructed intestines.