Gastrointest Interv.  2016 Jul;5(2):124-128. 10.18528/gii150017.

Endoscopic approaches to afferent and Roux-en-Y limb obstruction

Affiliations
  • 1Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA, USA. Richard.Kozarek@virginiamason.org

Abstract

Afferent limb syndrome can be seen following Billroth II gastric resection, Whipple procedure with duodenojejunostomy, or in association with an obstructed Roux-en-Y limb following hepaticojejunostomy. This syndrome classically presents with jaundice or cholangitis but may also be associated with abdominal pain alone or pancreatitis, especially in patients with surgically created pancreaticojejunostomies. Obstructions may be a consequence of benign or malignant disorders. Historically treated with surgery or percutaneous transhepatic biliary drainage, this review describes currently applied and evolving endoscopic techniques to include balloon dilation, double pigtail plastic stent placement, and insertion of self-expandable metal stents or lumen-apposing stents.

Keyword

Afferent limb; Biliary obstruction; Cholangitis; Roux-en-Y; Small bowel obstruction

MeSH Terms

Abdominal Pain
Cholangitis
Drainage
Extremities*
Gastroenterostomy
Humans
Jaundice
Pancreaticojejunostomy
Pancreatitis
Plastics
Stents
Plastics
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