title: Acute pancreatitis as an adverse event in patients with the duodenal-jejunal bypass liner.
abstract: Placement of the duodenal-jejunal bypass liner (DJBL) is a minimally invasive technique for the management of patients with type 2 diabetes mellitus and obesity. Acute pancreatitis was seen in 5 of 167 patients (3 %) in our series. It is suggested that acute pancreatitis in patients with the DJBL results from either direct blockage or edema of the major duodenal papilla, which may be caused by the following: migration of the anchor of the DJBL, accumulation of food debris between the liner and the duodenal wall, or reflux of duodenal contents into the pancreatic duct due to intraluminal hypertension caused by the liner. Early removal of the DJBL resulted in fast and complete recovery, whereas delayed diagnosis and removal led to severe, necrotizing acute pancreatitis.
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Bark
authors.initials: B
authors.lastname: Betzel
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Jens
authors.initials: J
authors.lastname: Homan
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Edo
authors.initials: E
authors.lastname: Aarts
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Ignace
authors.initials: I
authors.lastname: Janssen
authors.affiliation: Department of Gastroenterology and Hepatology, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Marcel
authors.initials: M
authors.lastname: Spanier
authors.affiliation: Department of Gastroenterology and Hepatology, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Wahab
authors.affiliation: Department of Gastroenterology and Hepatology, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Marcel
authors.initials: M
authors.lastname: Groenen
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Frits
authors.initials: F
authors.lastname: Berends
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000295:instrumentation*; D020878:Device Removal; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery*; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome