Abstract
A 77-year-old woman underwent pancreaticoduodenectomy (PD) with modified Child reconstruction for pancreatic carcinoma. Seven months postoperatively, she developed high-grade fever and right upper abdominal pain. The clinical diagnosis was suppurative cholangitis. Abdominal contrast-enhanced computed tomography showed afferent loop obstruction due to residual tumor. An intestinal tube was inserted using a guidewire placed by single-balloon enteroscopy and her clinical condition improved quickly. On the 10th day after insertion, the tube was removed and a self-expanding metallic stent (Wall Flex duodenal stent) was placed across the stricture. The patient did well and had an improved quality of life until she died 45 days later.
In conclusion, endoscopic stenting appears to be a useful procedure for malignant afferent loop obstruction after PD because it is less invasive.
