Candy cane syndrome:A systematic review  

作　　者：Ricardo Rio-Tinto Jorge Canena Jacques Devière 

机构地区：[1]Digestive Oncology Unit,Champalimaud Foundation,Lisbon 1600,Lisbon,Portugal [2]Centro de Gastrenterologia,Hospital CUF Tejo-Nova Medical School/Faculdade de Ciências Médicas da UNL,Lisbon 1600,Lisbon,Portugal [3]Serviço de Gastrenterologia,Hospital Amadora-Sintra,Amadora 1600,Lisbon,Portugal [4]Serviço de Gastrenterologia,Hospital de Santo António dos Capuchos-CHLC,Lisbon 1600,Lisbon,Portugal [5]Cintesis-Center for Health Technology and Services Research,Universidade do Minho,Braga 1600,Braga,Portugal [6]Department of Gastroenterology,Hepatopancreatology,and Digestive Oncology,Erasme Hospital-UniversitéLibre de Bruxelles,Brussels 1050,Brussels,Belgium

出　　处：《World Journal of Gastrointestinal Endoscopy》2023年第7期510-517,共8页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND Candy cane syndrome(CCS)is a condition that occurs following gastrectomy or gastric bypass.CCS remains underrecognized,yet its prevalence is likely to rise due to the obesity epidemic and increased use of bariatric surgery.No previous literature review on this subject has been published.AIM To collate the current knowledge on CCS.METHODS A literature search was conducted with PubMed and Google Scholar for studies from May 2007,until March 2023.The bibliographies of the retrieved articles were manually searched for additional relevant articles.RESULTS Twenty-one articles were identified(135 patients).Abdominal pain,nausea/vomiting,and reflux were the most reported symptoms.Upper gastrointestinal(GI)series and endoscopy were performed for diagnosis.Surgical resection of the blind limb was performed in 13 studies with resolution of symptoms in 73%-100%.In surgical series,9 complications were reported with no mortality.One study reported the surgical construction of a jejunal pouch with clinical success.Six studies described endoscopic approaches with 100%clinical success and no complications.In one case report,endoscopic dilation did not improve the patient’s symptoms.CONCLUSION CCS remains underrecognized due to lack of knowledge about this condition.The growth of the obesity epidemic worldwide and the increase in bariatric surgery are likely to increase its prevalence.CCS can be prevented if an elongated blind loop is avoided or if a jejunal pouch is constructed after total gastrectomy.Diagnosis should be based on symptoms,endoscopy,and upper GI series.Blind loop resection is curative but complex and associated with significant complications.Endoscopic management using different approaches to divert flow is effective and should be further explored.

关 键 词：Candy cane syndrome Blind pouch syndrome Post-gastrectomy syndromes Side-to-side enteral anastomosis End-to-side enteral anastomosis 

分 类 号：R656.6[医药卫生—外科学]