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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World Journal of Gastrointestinal Surgery. Sep 27, 2015; 7(9): 190-195
Published online Sep 27, 2015. doi: 10.4240/wjgs.v7.i9.190
Published online Sep 27, 2015. doi: 10.4240/wjgs.v7.i9.190
Management of afferent loop obstruction: Reoperation or endoscopic and percutaneous interventions?
Konstantinos Blouhos, Konstantinos Andreas Boulas, Anestis Hatzigeorgiadis, Department of General Surgery, General Hospital of Drama, 66100 Drama, Greece
Konstantinos Tsalis, D’ Surgical Department, “G. Papanikolaou” Hospital, Medical School, Aristotle University of Thessaloniki, 54645 Thessaloniki, Greece
Author contributions: Blouhos K designed the research; Boulas KA performed the literature research and wrote the paper; Hatzigeorgiadis A substantially contributed in editing the English language of the manuscript; Tsalis K and Hatzigeorgiadis A made critical revisions related to important intellectual content of the manuscript and had the final approval of the version of the article to be published.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Konstantinos Andreas Boulas, MD, MSc, Department of General Surgery, General Hospital of Drama, End of Hippokratous Street, 66100 Drama, Greece. katerinantwna@hotmail.com
Telephone: +30-693-7265675 Fax: +30-251-3501559
Received: March 23, 2015
Peer-review started: March 26, 2015
First decision: June 3, 2015
Revised: June 21, 2015
Accepted: July 21, 2015
Article in press: July 23, 2015
Published online: September 27, 2015
Processing time: 187 Days and 17.5 Hours
Peer-review started: March 26, 2015
First decision: June 3, 2015
Revised: June 21, 2015
Accepted: July 21, 2015
Article in press: July 23, 2015
Published online: September 27, 2015
Processing time: 187 Days and 17.5 Hours
Core Tip
Core tip: Management strategy of afferent loop obstruction (ALO) depends on: (1) the benign or malignant nature of the obstruction. ALO caused by a benign lesion needs definitive repair of the primary cause by surgery. ALO caused by a malignant lesion needs palliative treatment (percutaneous and endoscopic interventions, by-pass surgery) or excision; and (2) the site of obstruction. An obstruction at the inframesocolic portion of the afferent loop can be easily reconstructed, whereas an obstruction at the supramesocolic portion needs copious mobilization and may require revision of the hepaticojejunostomy or pancreaticojejunostomy and/or a modified Puestow procedure in the setting of a preceded pancreaticoduodenectomy.