Obstructive Jaundice after Bilioenteric Anastomosis: Transhepatic and Direct Percutaneous Enteral Stent Insertion for Afferent Loop Occlusion
Gut and Liver
;
: S89-S95, 2010.
Artigo
em Inglês
| WPRIM
| ID: wpr-12328
ABSTRACT
Recurrent tumour after radical pancreaticoduodenectomy may cause obstruction of the small bowel loop draining the liver. Roux-loop obstruction presents a particular therapeutic challenge, since the postsurgical anatomy usually prevents endoscopic access. Careful multidisciplinary discussion and multimodality preprocedure imaging are essential to accurately demonstrate the cause and anatomical location of the obstruction. Transhepatic or direct percutaneous stent placement should be possible in most cases, thereby avoiding long-term external biliary drainage. Gastropexy T-fasteners will secure the percutaneous access and reduce the risk of bile leakage. The static bile is invariably contaminated by gut bacteria, and systemic sepsis is to be expected. Enteral stents are preferable to biliary stents, and compound covered stents in a sandwich construction are likely to give the best long-term results. Transhepatic and direct percutaneous enteral stent insertion after jejunopexy is illustrated and the literature reviewed.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Bactérias
/
Bile
/
Anastomose em-Y de Roux
/
Jejunostomia
/
Stents
/
Drenagem
/
Colestase
/
Pancreaticoduodenectomia
/
Sepse
/
Icterícia Obstrutiva
Idioma:
Inglês
Revista:
Gut and Liver
Ano de publicação:
2010
Tipo de documento:
Artigo
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