PERCUTANEOUS TRANSHEPATIC DUODENAL DRAINAGE AS AN ALTERNATIVE APPROACH IN AFFERENT LOOP OBSTRUCTION WITH SECONDARY OBSTRUCTIVE-JAUNDICE IN RECURRENT GASTRIC-CANCER

Two cases are reported of chronic, partial afferent loop obstruction w ith resultant obstructive jaundice in recurrent gastric cancer. The di agnosis was made by characteristic clinical presentations, abdominal c omputed tomography, and cholescintigraphy. Percutaneous transhepatic d uodenal drainage (PTDD) provided effective palliation for both afferen t loop obstruction and biliary stasis. We conclude that cholescintigra phy is of value in making the diagnosis of partial afferent loop obstr uction and in differentiating the cause of obstructive jaundice in suc h patients, and PTDD provides palliation for those patients in whom su rgical intervention is not feasible.