Sump-syndrome Resurfaces: Endoscopic Biliary Drainage in the Spotlight

Sump-syndrome is a rare pathology that arises as a consequence of surgical interventions on the biliary tract. Previously, the widely used technique of side-to-side anastomosis between the common bile duct and the duodenum contributed to the formation of a poorly drained reservoir in the distal bile duct, leading to recurrent infections and pancreatic complications. Modern endoscopic methods, such as sphincterotomy and biliary drainage, have virtually eliminated this syndrome. However, the recent development of endoscopic choledochoduodenostomy may bring it back into clinical relevance. This article presents a clinical case of a 52-year-old patient with sump-syndrome following endoscopic choledochoduodenostomy performed for unresectable pancreatic head cancer. The patient was admitted with symptoms of cholangitis and elevated inflammatory markers. Diagnosis and treatment included antibiotic therapy and supportive care. This case highlights the importance of considering sump syndrome in the differential diagnosis of abdominal pain in patients with prior biliary interventions and emphasizes the need to assess the risks associated with different biliary drainage techniques.