{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:45:29Z","timestamp":1791254729933,"version":"4.1.0"},"reference-count":34,"publisher":"International College of Surgeons","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:p>We report a 71-year-old man who had undergone pylorus-preserving pancreatoduodenectomy (PPPD) using PPPD-IV reconstruction for cholangiocarcinoma. For 6 years thereafter, he had suffered recurrent cholangitis, and also a right liver abscess (S5\/8), which required percutaneous drainage at 9 years after PPPD. At 16 years after PPPD, he had been admitted to the other hospital because of acute purulent cholangitis. Although medical treatment resolved the cholangitis, the patient was referred to our hospital because of dilatation of the intrahepatic biliary duct (B2). Peroral double-balloon enteroscopy revealed that the diameter of the hepaticojejunostomy anastomosis was 12 mm, and cholangiography detected intrahepatic stones. Lithotripsy was performed using a basket catheter. At 1 year after lithotripsy procedure, the patient is doing well. Hepatobiliary scintigraphy at 60 minutes after intravenous injection demonstrated that deposit of the tracer still remained in the upper afferent loop jejunum. Therefore, we considered that the recurrent cholangitis, liver abscess, and intrahepatic lithiasis have been caused by biliary stasis due to nonobstructive afferent loop syndrome. Biliary retention due to nonobstructive afferent loop syndrome may cause recurrent cholangitis or liver abscess after hepaticojejunostomy, and double-balloon enteroscopy and hepatobiliary scintigraphy are useful for the diagnosis of nonobstructive afferent loop syndrome.<\/jats:p>","DOI":"10.9738\/intsurg-d-13-00243.1","type":"journal-article","created":{"date-parts":[[2014,7,24]],"date-time":"2014-07-24T19:24:38Z","timestamp":1406229878000},"page":"426-431","source":"Crossref","is-referenced-by-count":21,"title":["Recurrent Cholangitis by Biliary Stasis Due to Non-Obstructive Afferent Loop Syndrome After Pylorus-Preserving Pancreatoduodenectomy: Report of a Case"],"prefix":"10.9738","volume":"99","author":[{"given":"Yukihiro","family":"Sanada","sequence":"first","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"},{"name":"Department of Transplant Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"},{"name":"Department of Transplant Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanobu","family":"Taguchi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazue","family":"Morishima","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Kasahara","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Kaneda","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Miki","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasunao","family":"Ishiguro","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Kurogochi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Koizumi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Sasanuma","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehito","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasunaru","family":"Sakuma","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanobu","family":"Hyodo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohiro","family":"Sata","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshikazu","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4721","reference":[{"issue":"3","key":"i0020-8868-99-4-426-b01","series-title":"J Hepatobiliary 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Pediatr Transplant2011;15(6):594\u2013600"},{"issue":"1","key":"i0020-8868-99-4-426-b31","series-title":"Transplant Proc","first-page":"201","article-title":"Nuclear imaging of the liver: is there a diagnostic role of HIDA in posttransplantation?","volume":"41","author":"Al Sofayan\n              MS,","year":"2009","unstructured":"Al Sofayan\n              MS, \n            \n              Ibrahim\n              A, \n            \n              Helmy\n              A, \n            \n              Al Saghier\n              MI, \n            \n              Al Sebayel\n              MI, \n            \n              Abozied\n              MM. \n          \n          Nuclear imaging of the liver: is there a diagnostic role of HIDA in posttransplantation?\n          Transplant Proc\n          2009;41(1):201\u2013207"},{"issue":"8","key":"i0020-8868-99-4-426-b32","series-title":"Clin Nucl Med","first-page":"638","article-title":"Hepatobiliary scintigraphy in liver transplant patients: the \u201cblind end sign\u201d and its differentiation from bile leak","volume":"28","author":"Young\n              SA,","year":"2003","unstructured":"Young\n              SA, \n            \n              Sfakianakis\n              GN, \n            \n              Pyrsopoulos\n              N, \n            \n              Nishida\n              S. \n          \n          Hepatobiliary scintigraphy in liver transplant patients: the \u201cblind end sign\u201d and its differentiation from bile leak. 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Transpl Infect Dis2007;9(4):327\u2013331"},{"issue":"8","key":"i0020-8868-99-4-426-b34","series-title":"Transplantation","first-page":"1307","article-title":"Successful treatment of recurrent cholangitis after adult liver transplantation with a Tsuchida antireflux valve","volume":"77","author":"Orlando\n              G,","year":"2004","unstructured":"Orlando\n              G, \n            \n              Blairvacq\n              JS, \n            \n              Otte\n              JB, \n            \n              Goffette\n              P, \n            \n              Ciccarelli\n              O, \n            \n              Sempoux\n              C\n            \n            et al\n          . Successful treatment of recurrent cholangitis after adult liver transplantation with a Tsuchida antireflux valve. 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