title: [Afferent Loop Syndrome after Hepatobiliary and Pancreatic Surgery Successfully Treated with Percutaneous Drainage].
abstract: We report 2 cases where afferent loop syndrome after hepatobiliary and pancreatic surgery was successfully treated with percutaneous drainage. Case 1: A 74-year-old man who had undergone pancreaticoduodenectomy for pancreatic cancer presented with cholangitis, obstructive jaundice, and dilatation of the elevated jejunum. These conditions were attributed to obstruction of the elevated jejunum on the anal side due to peritoneal dissemination. Subsequently, percutaneous transhepatic biliary drainage was performed, and the dilated jejunum was drained through the approach route. Case 2: A 71-year-old woman who had undergone left hepatectomy for hilar bile duct cancer presented with peritoneal dissemination. Owing to the dissemination, the elevated jejunum was obstructed, resulting in its dilatation on the oral side. Percutaneous drainage of the dilated jejunum was directly performed. Percutaneous drainage was effective in both the abovementioned cases, and no symptoms related to the obstruction were observed until the death of the patients because of primary cancer. This suggested that percutaneous drainage may be an effective treatment option for afferent loop syndrome after hepatobiliary and pancreatic surgery.
authors.affiliation: Dept. of Surgery, Toyonaka Municipal Hospital.
authors.forename: Terukazu
authors.initials: T
authors.lastname: Yoshihara
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tomimaru
authors.forename: Kaishu
authors.initials: K
authors.lastname: Tanaka
authors.forename: Kozo
authors.initials: K
authors.lastname: Noguchi
authors.forename: Shiro
authors.initials: S
authors.lastname: Hayashi
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Nagase
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hamabe
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirota
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Oshima
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Tanida
authors.forename: Tomono
authors.initials: T
authors.lastname: Kawase
authors.forename: Shunji
authors.initials: S
authors.lastname: Morita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwazawa
authors.forename: Kenzo
authors.initials: K
authors.lastname: Akagi
authors.forename: Keizo
authors.initials: K
authors.lastname: Dono
mesh_terms: D000343:Afferent Loop Syndrome / Q000209:etiology / Q000628:therapy*; D000368:Aged; D001650:Bile Duct Neoplasms / Q000601:surgery; D004322:Drainage; D017809:Fatal Outcome; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*