Clin Endosc.  2013 Jan;46(1):59-64. 10.5946/ce.2013.46.1.59.

Self-Expandable Metallic Stent Placement in the Palliative Treatment of Malignant Obstruction of Gastric Outlet and Duodenum

• Caglar E
• Dobrucali

• KMID: 1792641
• DOI: http://doi.org/10.5946/ce.2013.46.1.59

Abstract

BACKGROUND/AIMS
To asses the usefulness of flexible metallic stents in the palliation of malignant obstruction of gastric outlet and duodenum.
METHODS
Retrospective review was performed between January 2006 and December 2011 in 30 patients. Thirty consecutive patients with obstruction of the gastric outlet underwent palliative treatment with self-expandable flexible metallic stents. Complications and clinical outcomes were assessed.
RESULTS
Twenty-four patients had advanced gastric carcinoma at the antrum and/or pylorus, four patients had obstruction at the pylorus due to pancreas tumours and one patient had duodedum and one patient had gall bladder tumour. Symptoms improved in 82.7% of the patients after the procedure. The improvement in ability to eat using the score system was statistically significant (p<0.001). Tumor ingrowth and/or overgrowth were seen in four patients (13.3%), and a second stent was inserted in these patients. The mean stent patency was 100 days (range, 5 to 410). The mean survival was 120.76+/-38.96 days.
CONCLUSIONS
Endoscopic placement of self-expendable metallic stents under fluoroscopy is a safe and effective treatment for the palliation of patients with inoperable malignant gastric outlet obstruction caused by stomach or pancreas cancer.

Keyword

Gastric outlet obstruction; Self expendable metallic stents; Advanced malignancies

MeSH Terms

Duodenum
Equidae
Fluoroscopy
Gastric Outlet Obstruction
Humans
Palliative Care
Pancreas
Pancreatic Neoplasms
Pylorus
Retrospective Studies
Stents
Stomach
Urinary Bladder

Figure

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  Fig. 1 Graphic shows gastric outlet obstruction scoring system of patients before and after stenting.

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  Fig. 2 Gastric stent images. (A) Proximal view of an opened stent after stenting. (B) Radiographic image after combined endoscopic biliary (thin arrow) and duodenal (arrow head) stenting for nonsurgical treatment of malignant biliary obstruction and malignant gastric outlet obstruction in a patient with pancreatic cancer.

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  Fig. 3 Kaplan Meier curve of patient survival after stent insertion.

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  Fig. 4 Kaplan Meier curve of stent patency.

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