Fig. 3

Overlong or twisted afferent loop cause endoscopic insertion failure. A In a case with overlong afferent loop, the length of the enteroscope was insufficient to reach bilioenteric anastomosis site. B Afferent loop between poke hole of the transverse mesocolon and bilioenteric anastomosis was severely twisted, causing failed endoscopic insertion. C The same patient in figure B was then received surgical treatment. Yellow line indicated twisted afferent loop. D After reconstructed the bilioenteric anastomosis, surgeons shortened the length of the afferent loop to facilitate subsequent endoscopic treatment