title: Management of afferent loop obstruction from recurrent metastatic pancreatic cancer using a venting gastrojejunostomy.
abstract: Pancreatic cancer is an aggressive malignancy potentially curable with surgical intervention. Following pancreaticoduodenectomy for suspected pancreatic head malignancy, patients have a high risk for both immediate and delayed problems due to surgical complications and recurrent disease. We report here a patient with pancreatic cancer treated with pancreaticoduodenectomy who developed recurrent disease resulting in obstruction of the afferent limb. The patient developed biliary obstruction and cholangitis at presentation. Her biliary tree failed to dilate which precluded safe percutaneous biliary decompression. During surgical exploration, she was found to have a dilated afferent limb at the level of the transverse mesocolon. The patient underwent decompression of the afferent limb as well as the biliary tree using a venting gastrojejunostomy to the blind loop. This represents a novel surgical approach for management of this complicated and difficult problem.
authors.affiliation: Debbie Bakes, Christian Cain, Xiang Da (Eric) Dong, Department of Surgery, Stamford Hospital, Affiliate of Columbia University, Stamford, CT 06904, United Sates.
authors.forename: Debbie
authors.initials: D
authors.lastname: Bakes
authors.affiliation: Debbie Bakes, Christian Cain, Xiang Da (Eric) Dong, Department of Surgery, Stamford Hospital, Affiliate of Columbia University, Stamford, CT 06904, United Sates.
authors.forename: Christian
authors.initials: C
authors.lastname: Cain
authors.affiliation: Debbie Bakes, Christian Cain, Xiang Da (Eric) Dong, Department of Surgery, Stamford Hospital, Affiliate of Columbia University, Stamford, CT 06904, United Sates.
authors.forename: Michael
authors.initials: M
authors.lastname: King
authors.affiliation: Debbie Bakes, Christian Cain, Xiang Da (Eric) Dong, Department of Surgery, Stamford Hospital, Affiliate of Columbia University, Stamford, CT 06904, United Sates.
authors.forename: Xiang Da Eric
authors.initials: Xda E
authors.lastname: Dong
keywords: Afferent loop; Biliary obstruction; Cholangitis; Gastrojejunostomy; Pancreatic cancer