Double-balloon enteroscope-assisted enteral stent placement for malignant afferent-loop obstruction after Roux-en-Y reconstruction

Abstract Background and study aims A short-type single-balloon enteroscope with a 3.2-mm working channel makes it possible to insert an enteral stent by the through-the-scope technique in patients with malignant afferent loop obstruction. Here, we report five cases of malignant afferent loop obstruction treated with endoscopic enteral stenting. We also propose a new classification for three types of malignant afferent loop obstruction. Type 1: The obstruction site is located distal to the papilla or the bilioenteric anastomosis. Type 2: The obstruction site is located at the papilla or the bilioenteric anastomosis. Type 3: The obstruction site is located between the bilioenteric and pancreaticoenteric anastomosis. The patients with type 1 and 3 were simply treated by inserting an enteral stent endoscopically. The patient with type 2 was treated with an endoscopic enteral stent for malignant afferent loop obstruction and with percutaneous transhepatic biliary stenting for malignant biliary obstruction. Although double stenting for type 2 remains a difficult endoscopic procedure, the endoscopic approach has become the standard approach for malignant afferent loop obstruction.

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Percutaneous Transhepatic Self-expanding Metallic Stent Placement for the Treatment of Malignant Afferent Loop Obstruction

Internal Medicine ◽

10.2169/internalmedicine.9382-17 ◽

2018 ◽

Vol 57 (3) ◽

pp. 333-337 ◽

Cited By ~ 2

Author(s):

Naruomi Jinno ◽

Itaru Naitoh ◽

Yoshihito Nagura ◽

Kazutoshi Fujioka ◽

Yusuke Mizuno ◽

...

Keyword(s):

Stent Placement ◽

Metallic Stent ◽

Afferent Loop ◽

Afferent Loop Obstruction ◽

Metallic Stent Placement

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Fluoroscopy guided stent placement for the treatment of malignant afferent loop obstruction

10.21203/rs.3.rs-208774/v1 ◽

2021 ◽

Author(s):

Chaoyang Wang ◽

Xiaoyi Duan ◽

Lequn Wei ◽

Tong Wang ◽

Huanzhang Niu

Keyword(s):

Tumor Progression ◽

Stent Placement ◽

Clinical Symptoms ◽

Operation Time ◽

The Other ◽

Efficacy And Safety ◽

Safe Method ◽

Afferent Loop ◽

Afferent Loop Obstruction

Abstract BACKGROUND & AIM: To evaluate the efficacy and safety of fluoroscopy guided stent placement for the treatment of malignant afferent loop obstruction (ALO). METHODS 12 patients with malignant ALO in whom fluoroscopy guided stent placement had been performed were analyzed retrospectively. The operation time, clinical efficacy, complications and postoperative hospitalization were observed. Follow-up was scheduled at 1 and 3 months after the operation, and every 3 months thereafter, or when the patients developed clinical symptoms related to ALO. RESULTS Stent placement was performed successfully in 11 patients with an average time of 37.9 ± 12.2 min. For the other one patient, we adopted transnasal drainage tube implantation in afferent loop instead of stent placement. All the patients had an obvious relief of clinical symptoms, and no serious complications occurred. During the follow-up, 1 patient had restenosis 12 months later as the tumor grew across the stent mesh. 7 patients died of tumor progression at 3, 4.5, 5, 7, 8, 11 and 15 months after the operation. CONCLUSION Fluoroscopy guided stent placement is an effective and safe method for the treatment of malignant ALO.

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