Sakai Arata, Shiomi Hideyuki, Okabe Yoshihiro, Yagi Yousuke, Kobayashi Takashi, Shiomi Yuuki, Takenaka Mamoru, Hoshi Namiko, Arisaka Yoshifumi, Kutsumi Hiromu, Azuma Takeshi
Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan,
Clin J Gastroenterol. 2015 Apr;8(2):103-7. doi: 10.1007/s12328-015-0556-0. Epub 2015 Feb 24.
Afferent loop obstruction caused by cancer recurrence after pancreaticoduodenectomy (PD) can be managed by either surgical or nonsurgical treatment. The general condition of patients with recurrent pancreaticobiliary cancer is often not good enough for them to undergo surgery, so less invasive nonsurgical treatment is desirable. We report a case of a 66-year-old male who had undergone PD for pancreatic head adenocarcinoma 10 months previously and who presented at our hospital with fever and jaundice due to afferent loop obstruction caused by pancreatic cancer recurrence. An endoscopic self-expandable metal stent (SEMS) was placed for afferent loop obstruction without any complications. He quickly recovered after SEMS placement. He retained a good quality of life by receiving chemotherapy until his death due to cancer progression. Our case indicates that this method could be an easy, effective, safe, and less invasive treatment, which may confer a better quality of life for patients with afferent loop obstruction due to cancer recurrence after PD.
胰十二指肠切除术（PD）后癌症复发导致的输入袢梗阻可通过手术或非手术治疗来处理。复发性胰胆管癌患者的一般状况往往较差，无法耐受手术，因此更倾向于采用侵入性较小的非手术治疗。我们报告一例66岁男性患者，该患者10个月前因胰头腺癌接受了PD手术，现因胰腺癌复发导致输入袢梗阻，以发热和黄疸症状来我院就诊。为其放置了内镜下自膨式金属支架（SEMS）以解除输入袢梗阻，未发生任何并发症。放置SEMS后他很快康复。在接受化疗直至因癌症进展死亡期间，他一直保持着较好的生活质量。我们的病例表明，这种方法可能是一种简便、有效、安全且侵入性较小的治疗方法，对于PD后因癌症复发导致输入袢梗阻的患者而言，或许能带来更好的生活质量。
