CASE REPORT article
Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1672367
Successful Endoscopic Duodenal Stent Placement for Afferent Loop Obstruction Following Billroth II Gastrectomy: A Case Report
Provisionally accepted
- Guangdong Provincial People's Hospital, Guangzhou, China
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Background: Afferent loop obstruction (ALO) is an uncommon but potentially life-threatening complication following Billroth II gastrectomy, with an estimated incidence of around 1%. It often presents with nonspecific symptoms such as postprandial vomiting and jaundice, making timely diagnosis and effective treatment crucial. Minimally invasive endoscopic techniques have emerged as promising alternatives to surgery. Case Presentation: We report the case of a 63-year-old woman with a history of Billroth II gastrectomy for gastric cancer who presented with progressive jaundice, nausea, and vomiting. Imaging revealed significant duodenal wall thickening consistent with ALO. Conventional endoscopic attempts to traverse the obstructed segment failed due to severe luminal narrowing and tortuosity. Under combined endoscopic and interventional radiologic guidance, a duodenal self-expanding metal stent was successfully deployed across the stricture, resulting in immediate symptom relief and biochemical improvement. Conclusion: Interventional-guided endoscopic stent placement is a safe, effective, and minimally invasive approach for managing malignant or benign ALO in post-gastrectomy patients. This hybrid technique may be particularly valuable in anatomically complex or surgically high-risk cases.
Keywords: Afferent loop obstruction, Billroth II gastrectomy, Endoscopic stent placement, interventional radiology, Gastrointestinal obstruction
Received: 24 Jul 2025; Accepted: 08 Oct 2025.
Copyright: © 2025 Ye, Peng, Zhuang and Mo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhiqiang Mo, mozhiqiang@gdph.org.cn
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