| Theme | Stenting for Digestive Diseases | |
|---|---|---|
| Title | Endoscopic self—expandable metal stent placement for afferent loop obstruction | |
| Publish Date | 2019/09 | |
| Author | Hirohisa Takeuchi | Department of Surgery, Kyorin University School of Medicine |
| Author | Hayato Shimoyama | Department of Surgery, Kyorin University School of Medicine |
| Author | Masanao Tsurumi | Department of Surgery, Kyorin University School of Medicine |
| Author | Yoshikazu Hashimoto | Department of Surgery, Kyorin University School of Medicine |
| Author | Atsuko Ooki | Department of Surgery, Kyorin University School of Medicine |
| Author | Gen Nagao | Department of Surgery, Kyorin University School of Medicine |
| Author | Yoshihiro Sakamoto | Department of Surgery, Kyorin University School of Medicine |
| Author | Eiji Sunami | Department of Surgery, Kyorin University School of Medicine |
| Author | Tadahiko Masaki | Department of Surgery, Kyorin University School of Medicine |
| Author | Toshiyuki Mori | Department of Surgery, Kyorin University School of Medicine |
| Author | Nobutsugu Abe | Department of Surgery, Kyorin University School of Medicine |
| [ Summary ] | Recently, endoscopic self‒expandable metal stent (SEMS) placement has been reported as a safe and useful minimally invasive treatment for malignant afferent loop obstruction (ALO). However, when the bowel segment to the lesions is long or tortuous, the peroral approach using the endoscopic route can be difficult. Therefore, we performed a two‒step SEMS placement, which confers several advantages. First, the initial intestinal tube can immediately decompress the dilated afferent loop. Second, other sites of stenosis can be evaluated after the initial procedure. Third, the intestinal tube can serve as a guide for SEMS placement. In other words, the 2‒step placement improves the patient’s clinical condition immediately during the acute phase of ALO, and reduces the relative technical difficulty of the endoscopic SEMS placement technique. Herein, the disease state, surgical management, and endoscopic SEMS placement (the 2‒step SEMS placement) for ALO are discussed. |
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