title: Effectiveness of endoscopic self-expandable metal stent placement for afferent loop obstruction caused by pancreatic cancer recurrence after pancreaticoduodenectomy.
abstract: Afferent loop obstruction caused by cancer recurrence after pancreaticoduodenectomy (PD) can be managed by either surgical or nonsurgical treatment. The general condition of patients with recurrent pancreaticobiliary cancer is often not good enough for them to undergo surgery, so less invasive nonsurgical treatment is desirable. We report a case of a 66-year-old male who had undergone PD for pancreatic head adenocarcinoma 10 months previously and who presented at our hospital with fever and jaundice due to afferent loop obstruction caused by pancreatic cancer recurrence. An endoscopic self-expandable metal stent (SEMS) was placed for afferent loop obstruction without any complications. He quickly recovered after SEMS placement. He retained a good quality of life by receiving chemotherapy until his death due to cancer progression. Our case indicates that this method could be an easy, effective, safe, and less invasive treatment, which may confer a better quality of life for patients with afferent loop obstruction due to cancer recurrence after PD.
authors.affiliation: Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan, arataz0946@gmail.com.
authors.forename: Arata
authors.initials: A
authors.lastname: Sakai
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shiomi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Okabe
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Yagi
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Shiomi
authors.forename: Mamoru
authors.initials: M
authors.lastname: Takenaka
authors.forename: Namiko
authors.initials: N
authors.lastname: Hoshi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Arisaka
authors.forename: Hiromu
authors.initials: H
authors.lastname: Kutsumi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Azuma
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000601:surgery; D000368:Aged; D004724:Endoscopy; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007579:Jejunal Diseases / Q000209:etiology / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000150:complications*; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011788:Quality of Life; D000069322:Self Expandable Metallic Stents