Laparoscopy in Afferent Loop Obstruction Presenting as Acute Pancreatitis

Author： Vettoretto Nereo Pettinato Giovanna Romessis Matheos Bravo Andrea Ferrari Barozzi Geraldine Giovanetti Maurizio

Publisher： Society of Laparoendoscopic Surgeons

ISSN： 1086-8089

Source： JSLS, Journal of the Society of Laparoendoscopic Surgeons, Vol.10, Iss.2, 2006-04, pp. : 270-274

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Abstract

Background: We describe an afferent loop obstruction caused by an adhesion band in a case of distal gastrectomy with Roux-en-Y end-to-side jejunal anastomosis for cancer.Methods: An initial clinical presentation of acute pancreatitis was ruled out by a computed tomography scan, which revealed intestinal obstruction; it was then confirmed on laparoscopy. Definitive treatment was laparoscopic adhesiolysis. A complete review of the literature concerning afferent loop obstructions is presented.Results: The treatment was successful, with minimal postoperative pain, and the 5-day hospital stay was uncomplicated. The patient remains asymptomatic at 1-year follow-up.Conclusions: The authors advocate minimally invasive surgery as a complete diagnostic and therapeutic alternative to emergency laparotomy in cases where afferent loop syndrome is suspected, and acknowledge that prompt surgery has a higher rate of success and reduces operative morbidity and mortality.