title: Percutaneous jejunostomy and stent placement for treatment of malignant Roux-en-Y obstruction: a case report.
abstract: Nineteen months after a Whipple procedure for pancreatic carcinoma, a 79-year-old woman developed recurrent tumoral strictures of the bile ducts and afferent Roux-en-Y limb with resultant jaundice, cholangitis, and liver abscess. Transhepatic abscess and biliary drainages were performed first. Afferent loop obstruction was too far from biliary anastomosis to be crossed via the transhepatic route. Percutaneous jejunostomy and stenting were performed to relieve the malignant afferent loop syndrome. After initial relief of symptoms, jaundice recurred in relation to peritoneal carcinomatosis progression and was treated with percutaneous jejunostomy drainage until patient's death. Therapeutic options of tumoral occlusion of afferent loops are reviewed.
authors.affiliation: Department of Radiology and Interventional Radiology, Hôpital Archet, 151 route de Saint Antoine de Ginestière, Nice, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Chevallier
authors.forename: Sebastien
authors.initials: S
authors.lastname: Novellas
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Motamedi
authors.forename: Jean
authors.initials: J
authors.lastname: Gugenheim
authors.forename: Philippe
authors.initials: P
authors.lastname: Brunner
authors.forename: Jean-Noël
authors.initials: JN
authors.lastname: Bruneton
mesh_terms: D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects*; D002779:Cholestasis / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000601:surgery*; D015607:Stents; D016896:Treatment Outcome