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Enteral stenting for gastric outlet obstruction and afferent limb syndrome following pancreaticoduodenectomy
BACKGROUND: Obstruction of the afferent or efferent limbs of a gastrojejunal anastomosis is a potential complication after pancreaticoduodenectomy (PD) resulting in either gastric outlet obstruction or afferent limb syndrome. The use of self-expanding metal stents for the management of anastomotic s...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hellenic Society of Gastroenterology
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4188946/ https://www.ncbi.nlm.nih.gov/pubmed/25332208 |
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author | Kwong, Wilson T. Fehmi, Syed M. Lowy, Andrew M. Savides, Thomas J. |
author_facet | Kwong, Wilson T. Fehmi, Syed M. Lowy, Andrew M. Savides, Thomas J. |
author_sort | Kwong, Wilson T. |
collection | PubMed |
description | BACKGROUND: Obstruction of the afferent or efferent limbs of a gastrojejunal anastomosis is a potential complication after pancreaticoduodenectomy (PD) resulting in either gastric outlet obstruction or afferent limb syndrome. The use of self-expanding metal stents for the management of anastomotic strictures after resection of pancreatic cancer has not been well studied. We present four such cases and review published data regarding this population. METHODS: Retrospective chart review and literature search. Outcomes were summarized with descriptive statistics. RESULTS: At our institution, 4 patients underwent metal stent placement for gastrojejunal obstruction after PD for pancreatic cancer. Enteral stents were placed in two patients across the afferent limb, in one patient across the efferent limb, and in another patient across both limbs. Similar cases in the literature revealed that the anastomotic stricture was malignant in 26 of 27 cases. Clinical improvement occurred in 88%. Afferent limb syndrome was successfully treated in 5 of 6 cases. Median survival was 3.5 months after stent placement. CONCLUSIONS: Effective palliation of both gastric outlet obstruction and afferent limb syndrome after PD can be provided with enteral stenting. Gastrojejunal strictures after PD for pancreatic cancer are usually malignant with median survival of 3.5 months after stent placement. |
format | Online Article Text |
id | pubmed-4188946 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Hellenic Society of Gastroenterology |
record_format | MEDLINE/PubMed |
spelling | pubmed-41889462014-10-20 Enteral stenting for gastric outlet obstruction and afferent limb syndrome following pancreaticoduodenectomy Kwong, Wilson T. Fehmi, Syed M. Lowy, Andrew M. Savides, Thomas J. Ann Gastroenterol Case Series BACKGROUND: Obstruction of the afferent or efferent limbs of a gastrojejunal anastomosis is a potential complication after pancreaticoduodenectomy (PD) resulting in either gastric outlet obstruction or afferent limb syndrome. The use of self-expanding metal stents for the management of anastomotic strictures after resection of pancreatic cancer has not been well studied. We present four such cases and review published data regarding this population. METHODS: Retrospective chart review and literature search. Outcomes were summarized with descriptive statistics. RESULTS: At our institution, 4 patients underwent metal stent placement for gastrojejunal obstruction after PD for pancreatic cancer. Enteral stents were placed in two patients across the afferent limb, in one patient across the efferent limb, and in another patient across both limbs. Similar cases in the literature revealed that the anastomotic stricture was malignant in 26 of 27 cases. Clinical improvement occurred in 88%. Afferent limb syndrome was successfully treated in 5 of 6 cases. Median survival was 3.5 months after stent placement. CONCLUSIONS: Effective palliation of both gastric outlet obstruction and afferent limb syndrome after PD can be provided with enteral stenting. Gastrojejunal strictures after PD for pancreatic cancer are usually malignant with median survival of 3.5 months after stent placement. Hellenic Society of Gastroenterology 2014 /pmc/articles/PMC4188946/ /pubmed/25332208 Text en Copyright: © Hellenic Society of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Series Kwong, Wilson T. Fehmi, Syed M. Lowy, Andrew M. Savides, Thomas J. Enteral stenting for gastric outlet obstruction and afferent limb syndrome following pancreaticoduodenectomy |
title | Enteral stenting for gastric outlet obstruction and afferent limb syndrome following pancreaticoduodenectomy |
title_full | Enteral stenting for gastric outlet obstruction and afferent limb syndrome following pancreaticoduodenectomy |
title_fullStr | Enteral stenting for gastric outlet obstruction and afferent limb syndrome following pancreaticoduodenectomy |
title_full_unstemmed | Enteral stenting for gastric outlet obstruction and afferent limb syndrome following pancreaticoduodenectomy |
title_short | Enteral stenting for gastric outlet obstruction and afferent limb syndrome following pancreaticoduodenectomy |
title_sort | enteral stenting for gastric outlet obstruction and afferent limb syndrome following pancreaticoduodenectomy |
topic | Case Series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4188946/ https://www.ncbi.nlm.nih.gov/pubmed/25332208 |
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