Percutaneous Transhepatic Bowel Stent Deployment: An Alternative Approach for Malignant Afferent Loop Obstruction Following Whipple’s Procedure

Zahid Khan Amin,Muhammad Shozab,Raana Kanwal,Atif Nawaz,Alishbah Ziad

doi:10.7759/cureus.15964

Abstract

Afferent loop syndrome is an uncommon postoperative complication. Currently, we lack a therapeutic option for treatment of malignant afferent loop obstruction following procedures like Whipple's. Here we present a case of afferent loop obstruction in a known case of pancreatic carcinoma, status after Whipple’s procedure, in which we used a percutaneous transhepatic approach to relieve the afferent loop obstruction using a self-expanding bare metal stent.

Highlights

One of the complications of a pancreaticoduodenectomy, known as Whipple’s procedure, is afferent loop obstruction, which can be fatal if the patient develops jaundice or cholangitis [1]
Afferent loop syndrome occurs as a result of partial or complete obstruction of the afferent limb along its course or at the anastomosis
Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work

Summary

Introduction

One of the complications of a pancreaticoduodenectomy, known as Whipple’s procedure, is afferent loop obstruction, which can be fatal if the patient develops jaundice or cholangitis [1]. The case of the patient was discussed again with the interventional radiologist to see if any further intervention was possible when he attended for a follow-up visit Following review of his images it was decided that if the malignant obstruction in the afferent loop could be traversed, a self-expanding metallic stent could be deployed to enable internal drainage but this would need to be done via a transhepatic approach. He was admitted electively for this procedure.

Discussion

Conclusions

Findings

Disclosures