Enteral self-expandable metal stent placement for malignant afferent limb syndrome using single-balloon enteroscope: report of five cases

Yane, Kei; Katanuma, Akio; Hayashi, Tsuyoshi; Takahashi, Kuniyuki; Kin, Toshifumi; Nagai, Kazumasa; Tanaka, Kazunari; Komatsu, Naohiro; Endo, Masato; Kobayashi, Yousuke; Takigawa, Yukiko; Utsunomiya, Ran

doi:10.1055/a-0739-7640

Cited by 11 publications

(19 citation statements)

References 10 publications

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“…During a PubMed search, we found 12 reports (23 patients) on the use of SEMS to treat malignant ALO that arises after PD (Table 3). [5][6][7][8][9][10][11][12][13][14][15][16] Clinical success was achieved in all cases, and no adverse events were encountered. Although the data were limited, no cases of SEMS obstruction were found.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the use of balloon-assisted endoscopy during SEMS placement for malignant ALO has been reported. 4,7,9,[11][12][13][14]16 Shimatani et al reported a case in which SEMS placement was used to treat ALO caused by cancer recurrence after PD, in which a newly developed, shorttype, double-balloon endoscope (S-DBE) (EI-580BT; Fujifilm, Tokyo, Japan) was used. 13 They claimed that the combined use of the new S-DBE, which had a 3.2-mm working channel, and SEMS with a 9 Fr delivery system enabled through-the-scope SEMS placement, which had been previously challenging because the large diameter of the SEMS delivery system did not allow stent deployment through the 2.8-mm working channels of the conventional S-DBE.…”

Section: Discussionmentioning

confidence: 99%

“…During a PubMed search, we found 12 reports (23 patients) on the use of SEMS to treat malignant ALO that arises after PD ( Table 3 ) [ 5 - 16 ]. Clinical success was achieved in all cases, and no adverse events were encountered.…”

Section: Discussionmentioning

confidence: 99%

“…All the patients in our series were treated using endoscopes of the conventional length. Recently, the use of balloon-assisted endoscopy during SEMS placement for malignant ALO has been reported [ 4 , 7 , 9 , 11 - 14 , 16 ]. Shimatani et al reported a case in which SEMS placement was used to treat ALO caused by cancer recurrence after PD, in which a newly developed, shorttype, double-balloon endoscope (S-DBE) (EI-580BT; Fujifilm, Tokyo, Japan) was used [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Self-Expandable Metal Stent Placement for Malignant Afferent Loop Obstruction After Pancreaticoduodenectomy: A Case Series and Review

et al. 2020

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In this study, we assessed a series of our cases in which endoscopic self-expandable metal stents (SEMSs) were used to treat malignant afferent loop obstruction (ALO) that arose after pancreaticoduodenectomy (PD). We retrospectively examined the records of 7 patients who underwent endoscopic SEMS placement for malignant ALO following PD. Clinical success was achieved in all cases. The median procedure time was 30 min (range, 15-50 min). There were no cases of stent occlusion, and no procedure-related adverse events were encountered. All patients died of their primary disease, and the median overall survival period was 155 days (range, 96-374 days). A re-intervention involving endoscopic ultrasound-guided hepaticogastrostomy combined with antegrade stenting was performed for obstructive jaundice and acute cholangitis in 1 case. In conclusion, endoscopic SEMS placement may be an effective and safe treatment for malignant ALO that arises after PD. Clin Endosc 2020 Mar 3. [Epub ahead of print]

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Endoscopic Self-Expandable Metal Stent Placement for Malignant Afferent Loop Obstruction After Pancreaticoduodenectomy: A Case Series and Review

et al. 2020

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“…Several case reports have demonstrated the efficacy of endoscopic self-expanding metal stent placement as a therapeutic strategy among these patients. [2][3][4] However, as demonstrated by our case, in patients with complete or even partial obstruction, enteral stent placement may not be optimal. In such patients, when surgery poses a significant risk of morbidity, construction of a gastroenterostomy using a lumen-apposing metal stent is an efficacious option.…”

Section: Discussionmentioning

confidence: 68%

Percutaneous- and EUS-guided gastroenterostomy for malignant afferent limb syndrome

Adoor

Smith

2020

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Efficacy and safety of endoscopic stent placement for afferent loop obstruction using a short double‐balloon endoscopy

et al. 2022

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Background Afferent loop obstruction (ALO) is a rare mechanical complication that occurs after gastrojejunostomy. Recently the use of double‐balloon endoscopy (DBE) can be useful for benign and malignant ALO. Methods We retrospectively identified 22 patients who underwent DBE for ALO from January 2009 to December 2020. We evaluated the efficacy and safety of short DBE treatment for ALO. Results Short DBE was able to reach an obstructive site in the afferent limb in all patients (100%) and was able to reach the blind end in 14 patients (64%). The technical success rate was 100%, and the clinical success rate was 95%. Procedure‐related adverse events occurred in two patients (9%). In the case of benign ALO, three of nine patients showed improvement in ALO with single stent placement. Two of nine patients improved after the replacement of the plastic stent (PS) two or three times. Four of nine patients continued with the replacement of PS. In the case of malignant ALO, the metallic stent was placed in 10 patients, and eight patients with metallic stents did not experience stent occlusion until they died. Reintervention was attempted in six patients (27%) with benign ALO but was not attempted in malignant ALO. Conclusions Treatments for ALO using the short DBE was effective and relatively safe because the technical and clinical success rates were very high and there were relatively low complications. Consequently, short DBE could be the first‐choice treatment for both benign and malignant ALO.

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Enteral self-expandable metal stent placement for malignant afferent limb syndrome using single-balloon enteroscope: report of five cases

Cited by 11 publications

References 10 publications

Endoscopic Self-Expandable Metal Stent Placement for Malignant Afferent Loop Obstruction After Pancreaticoduodenectomy: A Case Series and Review

Endoscopic Self-Expandable Metal Stent Placement for Malignant Afferent Loop Obstruction After Pancreaticoduodenectomy: A Case Series and Review

Percutaneous- and EUS-guided gastroenterostomy for malignant afferent limb syndrome

Efficacy and safety of endoscopic stent placement for afferent loop obstruction using a short double‐balloon endoscopy

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