Percutaneous transhepatic insertion of metal stents with a double-pigtail catheter in afferent loop obstruction following distal gastrectomy
Yoshida, H.; Mamada, Y.; Taniai, N.; Kawano, Y.; Mizuguchi, Y.; Shimizu, T.; Takahashi, T.; Okuda, T.; Miyashita, M.; Tajiri, T.
Hepato-Gastroenterology 52(63): 680-682
2005
ISSN/ISBN: 0172-6390 PMID: 15966181 Document Number: 588385
We report successful outcome following transhepatic insertion of metal stents with a double-pigtail catheter in a patient with afferent loop syndrome caused by recurrent gastric carcinoma. A 77-year-old man was admitted with a 2-week history of fever, right upper quadrant pain, and jaundice. His past medical history included distal gastrectomy for treatment of gastric cancer two years previously. Abdominal computed tomography revealed marked dilation of the jejunal limb and intrabepatic bile duct. We diagnosed the patient with afferent loop syndrome resulting from recurrent cancer. Percutaneous transhepatic biliary drainage was performed, and a catheter was placed beyond the papilla of Vater. Approximately 1300ml, of turbid jejunal contents were removed. Symptoms resolved by one day after initiation of drainage. After 1 week, a sheath introducer was inserted beyond the point of stenosis, and two metal stents were placed. A double-pigtail catheter was inserted into the metal stents to prevent migration. Good stent placement was confirmed and the drainage catheter was removed.