A 76-year-old male with past history of distal gastrectomy/Billroth2 construction was developed hepatic disorder and jaundice. He was undergoing palliative therapy for refractory pancreatic cancer. Abdominal contrast-enhanced computed tomography revealed obstructive jaundice derived from afferent loop syndrome caused by direct invasion of the pancreatic cancer. The endoscopic drainage tube was inserted urgently and his clinical condition improved immediately. Four days later, we implanted metallic stent (Wallflex duodenal stent) into the stricture in exchange for the tube. After the procedure, afferent loop syndrome never relapsed for 2 months until he died from pancreatic cancer. Although the endoscopic therapy for malignant afferent loop syndrome with obstructive jaundice was rarely reported, the present case indicated endoscopic stenting would effectively improve the patients' quality of life.
