Endoscopy 2015; 47(11): 1050-1053
DOI: 10.1055/s-0034-1392226
Case series
© Georg Thieme Verlag KG Stuttgart · New York

Acute pancreatitis as an adverse event in patients with the duodenal-jejunal bypass liner

Bark Betzel
1   Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands
,
Jens Homan
1   Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands
,
Edo Aarts
1   Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands
,
Ignace Janssen
1   Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands
,
Marcel Spanier
2   Department of Gastroenterology and Hepatology, Rijnstate Hospital, Arnhem, the Netherlands
,
Peter Wahab
2   Department of Gastroenterology and Hepatology, Rijnstate Hospital, Arnhem, the Netherlands
,
Marcel Groenen
2   Department of Gastroenterology and Hepatology, Rijnstate Hospital, Arnhem, the Netherlands
,
Frits Berends
1   Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands
› Author Affiliations
Further Information

Publication History

submitted 03 February 2015

accepted after revision 02 April 2015

Publication Date:
28 May 2015 (online)

Preview

Placement of the duodenal-jejunal bypass liner (DJBL) is a minimally invasive technique for the management of patients with type 2 diabetes mellitus and obesity. Acute pancreatitis was seen in 5 of 167 patients (3 %) in our series. It is suggested that acute pancreatitis in patients with the DJBL results from either direct blockage or edema of the major duodenal papilla, which may be caused by the following: migration of the anchor of the DJBL, accumulation of food debris between the liner and the duodenal wall, or reflux of duodenal contents into the pancreatic duct due to intraluminal hypertension caused by the liner. Early removal of the DJBL resulted in fast and complete recovery, whereas delayed diagnosis and removal led to severe, necrotizing acute pancreatitis.