CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(07): E806-E811
DOI: 10.1055/a-0605-3508
Case report
Owner and Copyright © Georg Thieme Verlag KG 2018

Enteral stent placement for malignant afferent loop obstruction by the through-the-scope technique using a short-type single-balloon enteroscope

Takashi Sasaki
Department of Gastroenterology, Cancer Institute Hospital of Japanese Foundation of Cancer Research, Koto-ku, Japan
,
Ikuhiro Yamada
Department of Gastroenterology, Cancer Institute Hospital of Japanese Foundation of Cancer Research, Koto-ku, Japan
,
Masato Matsuyama
Department of Gastroenterology, Cancer Institute Hospital of Japanese Foundation of Cancer Research, Koto-ku, Japan
,
Naoki Sasahira
Department of Gastroenterology, Cancer Institute Hospital of Japanese Foundation of Cancer Research, Koto-ku, Japan
› Author Affiliations
Further Information

Publication History

submitted 10 February 2018

accepted after revision 03 April 2018

Publication Date:
04 July 2018 (online)

Abstract

Background and study aims A short-type single-balloon enteroscope with a 3.2-mm working channel makes it possible to insert an enteral stent by the through-the-scope technique in patients with malignant afferent loop obstruction. Here, we report five cases of malignant afferent loop obstruction treated with endoscopic enteral stenting. We also propose a new classification for three types of malignant afferent loop obstruction. Type 1: The obstruction site is located distal to the papilla or the bilioenteric anastomosis. Type 2: The obstruction site is located at the papilla or the bilioenteric anastomosis. Type 3: The obstruction site is located between the bilioenteric and pancreaticoenteric anastomosis. The patients with type 1 and 3 were simply treated by inserting an enteral stent endoscopically. The patient with type 2 was treated with an endoscopic enteral stent for malignant afferent loop obstruction and with percutaneous transhepatic biliary stenting for malignant biliary obstruction. Although double stenting for type 2 remains a difficult endoscopic procedure, the endoscopic approach has become the standard approach for malignant afferent loop obstruction.