The obstructed afferent loop: Percutaneous options
Gastrointestinal Intervention
; : 129-137, 2016.
Article
in En
| WPRIM
| ID: wpr-167191
Responsible library:
WPRO
ABSTRACT
Endoscopic drainage can be considered the treatment of choice in benign and malignant obstruction of the distal biliary tree, with percutaneous intervention reserved for cases of difficult access or complex hilar strictures. However in patients with altered anatomy due to pancreatico-duodenectomy gastrectomy, or Bilroth II reconstruction, endoscopy can be exceptionally challenging and often impossible. Surgery remains the gold standard for benign causes of obstruction of a bilio-enteric anastomosis or afferent loop, and percutaneous management remains controversial. Novel endoscopic techniques such as double balloon enteroscopy and endoscopic ultrasound guided procedures can overcome some of the anatomical challenges, but a percutaneous approach is a more established technique for cases of malignant obstruction of a bilio-enteric anastomosis or afferent loop. The altered anatomy presents unique challenges which must be fully contemplated and understood before intervention should occur, to avoid the risk of permanent external drainage.
Key words
Full text:
1
Index:
WPRIM
Main subject:
Bile Ducts
/
Biliary Tract
/
Biliary Tract Neoplasms
/
Drainage
/
Ultrasonography
/
Constriction, Pathologic
/
Afferent Loop Syndrome
/
Endoscopy
/
Double-Balloon Enteroscopy
/
Self Expandable Metallic Stents
Type of study:
Diagnostic_studies
Limits:
Humans
Language:
En
Journal:
Gastrointestinal Intervention
Year:
2016
Type:
Article