[Sump syndrome. Treatment by endoscopic biliary "rendez-vous" procedure]

Area of Science:

• Gastroenterology and Hepatology
• Surgical Complications
• Endoscopic Procedures

Background:

• Sump syndrome is a complication of biliary-enteric anastomosis where the distal bile duct fails to drain.
• It can lead to retained bile, food particles, and recurrent cholangitis.
• The incidence after side-to-side choledochoduodenostomy is less than 10%.

Observation:

• A case of sump syndrome following side-to-side choledochoduodenostomy for choledocholithiasis is presented.
• The patient developed symptoms indicative of sump syndrome.
• Papillary stenosis prevented standard endoscopic access to the biliary tree.

Findings:

• Endoscopic sphincterotomy is the preferred treatment for sump syndrome.
• When the major papilla is inaccessible, a biliary endoscopic rendezvous (BER) procedure is an alternative.
• The BER procedure successfully navigated the biliary tree via the choledochoduodenostomy.

Implications:

• This case highlights the utility of the BER procedure for managing sump syndrome.
• It provides a valuable alternative when transpapillary access is compromised.
• Successful management of sump syndrome improves patient outcomes and reduces cholangitis risk.