초록 열기/닫기 버튼
들창자 증후군의 비수술적 치료 방법은 다양하지만 언제나 모든 방법이 다 적용 가능한 것은 아니다. 특히 내시경적치료 방법은 해부학적 변형으로 인해 병변으로의 접근에 제한점이 있다. 이에 저자들은 악성 종양으로 인한 들창자 증후군 환자에서 2개의 내시경을 이용하여 성공적으로 금속스텐트를 삽입한 사례를 문헌 고찰과 함께 보고하는 바이다.
Afferent loop syndrome is a rare complication of pancreaticoduodenectomy, and the endoscopic approach is difficult due to the surgically altered anatomy. Herein, we report a case of afferent loop obstruction treated by endoscopic metal stent insertion using two endoscopes. A 57-year-old male who had undergone the Whipple operation 7 months prior for pancreatic head cancer presented with abdominal pain and jaundice. Abdominal computed tomography showed afferent loop obstruction due to recurrent metastatic pancreatic cancer. First, we attempted to insert the stent using percutaneous transhepatic approaches following percutaneous transhepatic biliary drainage, but these failed. We therefore accessed the obstruction site using a relatively thin endoscope and then exchanged this endoscope for another with a large working channel, through which the self-expandable metal stent was passed. The stent was inserted successfully. This method will increase the success rate of endoscopic treatment.
키워드열기/닫기 버튼
Afferent loop syndrome, Pancreaticoduodenectomy, Pancreatic neoplasm, Endoscopy
