The Role of Endoscopic Management in Afferent Loop Syndrome

• Published in: Gut and liver Vol. 17; no. 3; pp. 351 - 359
• Main Authors: Clement Chun Ho Wu, Elizabeth Brindise, Rami El Abiad, Mouen A. Khashab
• Format: Journal Article
• Language: Korean
• Published: 대한소화기내시경학회 30.05.2023
• Subjects: Afferent loop syndrome; Endoscopic ultrasonography; Enterostomy; Gastrojejunostomy; Self expandable metal stent
• ISSN: 1976-2283

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)