Magnetic Resonance Cholangiopancreatography for Afferent Loop Syndrome

Ashida, Akio; Tamura, Isao; Kumagiri, Yutaka; Fukano, Fumiyasu; Suzuki, Shinichiro; Rino, Yasushi; Imada, Toshio

doi:10.1111/j.1445-2197.2007.04365.x

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…In over 80% of the cases in our study, ALS was confirmed by CT scan. Magnetic resonance cholangiopancreatography (MRCP) can be a very useful guide in the operation for ALS, whereas modern MDCT scanners can easily provide coronal reformats that would give similar information to the image provided by MRCP [ 10 ]. The ultrasonographic appearance of ALS is that of a large dilated bowel loop in the mid abdomen, but it is difficult to differentiate confidently from a pancreatic pseudocyst [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic metal enteral stent placement for malignant afferent loop syndrome after pancreaticoduodenectomy.

Huang¹,

Hao²,

Yang³

et al. 2015

Videosurgery and Other Miniinvasive Techniques

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IntroductionAfferent loop syndrome (ALS) is a rare and dreaded complication after pancreaticoduodenectomy (PD). Malignant ALS after PD is usually difficult to manage due to patients’ poor condition. Effective and safe therapeutic strategies for these patients are reported scarcely at present.AimTo analyze and evaluate the clinical characteristics and treatment of these patients.Material and methodsWe analyzed 3 patients with malignant ALS after PD. They were treated by endoscopic enteral metal stent placement in our hospital. Meanwhile we retrospectively reviewed 49 cases with ALS after PD through available English literature. All these patients’ clinical features, laboratory study, treatment and outcome were evaluated.ResultsA total of 52 cases were analyzed in the study. The most common presenting symptoms of ALS after PD were jaundice (56.5%), upper abdominal pain (45.7%), fever (26.1%), and vomiting (23.9%). Sixty percent of ALS cases were caused by tumor recurrence. The mean time from prior surgery to diagnosis of ALS was 13.3 months. The rates of treatment with the endoscopic approach, percutaneous stenting or drainage, surgery, and the conservative method were 40.4%, 32.7%, 11.5%, and 15.4%, respectively. Endoscopic enteral metal stent placement proved more effective and less invasive in the treatment of malignant ALS after PD.ConclusionsCholangitis and cholangiectasis are the major manifestations of malignant ALS after PD. Invasive interventions are enjoying more and more acceptance for treatment. Endoscopic enteral metal stent placement appears to be a promising technique with effective palliation in these patients.

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Section: Discussionmentioning

confidence: 99%

Endoscopic metal enteral stent placement for malignant afferent loop syndrome after pancreaticoduodenectomy.

Huang¹,

Hao²,

Yang³

et al. 2015

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

show abstract

“…The following findings are quite characteristic: The dilated afferent limb is found in the mid‐abdomen; it is typically located in the horizontal part of the duodenum, coming across between the aorta and the superior mesenteric vessels and displacing these vessels to the ventral side [8, 14]. Magnetic resonance cholangiopancreatography is also a useful guide prior to the operation for afferent loop obstruction during which the surgeons must deal with a fragile dilated intestine in an adherent surgical area [15].…”

Section: Discussionmentioning

confidence: 99%