Transhepatic placement of an enteral stent to treat jaundice in a tumor recurrence obstructed afferent loop after a whipple procedure.

ABSTRACT

Tumour recurrence that obstructs the afferent limb, blocking outflow of bile and pancreatic juice, constitutes a major clinical problem after a Whipple procedure. The endoscopic route is often not a possible alternative. Surgery may be difficult and perhaps dangerous to the often very sick patient and decompression with fine bore catheters may lead to cholangitis. External drainage is inconvenient to the patient. The present case describes a less invasive method to provide adequate drainage of the obstructed jejunal limb by insertion of a 22-mm enteral Wallstent transhepatically. The patient became and stayed anicteric during 7 months' follow-up.