Gut Liver.
2023 May;17(3):351-359. 10.5009/gnl220205.
The Role of Endoscopic Management in Afferent Loop Syndrome
- Affiliations
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- 1Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
- 2Duke-NUS Medical School, Singapore
- 3Division of Gastroenterology and Hepatology, Department of Medicine, University of Iowa, Iowa City, IA, USA.
- 4Division of Gastroenterology and Hepatology, The Johns Hopkins Hospital, Baltimore, MD, USA
- KMID: 2542337
- DOI: http://doi.org/10.5009/gnl220205
Abstract
- Afferent loop syndrome (ALS) is a morbid complication that may occur after gastrectomy and gastrojejunostomy reconstruction. The aim of this article is to review the different endoscopic treatment options of ALS. We describe the evolution of the endoscopic treatment of ALS and its limitations despite the overall propitious profile. We analyze the advantages of endoscopic ultrasound-guided entero-enterostomy (EUS EE) over enteroscopy-guided intervention, and the clinical outcomes of EUS EE. We expound on pre-procedural considerations, intra-procedural techniques and post-procedural care following EUS EE. We conclude that given the simplification of the technique and the ability to place a stent away from the tumor, EUS EE is a promising technique that will likely be established as the treatment of choice for ALS.
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