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The Role of Endoscopic Management in Afferent Loop Syndrome
Journal article   Open access   Peer reviewed

The Role of Endoscopic Management in Afferent Loop Syndrome

Clement Chun Ho Wu, Elizabeth Brindise, Rami El Abiad and Mouen A. Khashab
Gut and liver, Vol.17(3), pp.351-359
05/30/2023
DOI: 10.5009/gnl220205
PMCID: PMC10191797
PMID: 36578193
url
https://doi.org/10.5009/gnl220205View
Published (Version of record) Open Access

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. (Gut Liver 2023;17:351-359)
Afferent loop syndrome Endoscopic ultrasonography Enterostomy Gastrojejunostomy Self expandable metal stent

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