Endoscopic management of unresectable malignant gastroduodenal obstruction with a nitinol uncovered metal stent: A prospective Japanese multicenter study

World J Gastroenterol. 2016 Apr 14;22(14):3837-44. doi: 10.3748/wjg.v22.i14.3837.

Abstract

Aim: To determine the safety and efficacy of endoscopic duodenal stent placement in patients with malignant gastric outlet obstruction.

Methods: This prospective, observational, multicenter study included 39 consecutive patients with malignant gastric outlet obstruction. All patients underwent endoscopic placement of a nitinol, uncovered, self-expandable metal stent. The primary outcome was clinical success at 2 wk after stent placement that was defined as improvement in the Gastric Outlet Obstruction Scoring System score relative to the baseline.

Results: Technical success was achieved in all duodenal stent procedures. Procedure-related complications occurred in 4 patients (10.3%) in the form of mild pneumonitis. No other morbidities or mortalities were observed. The clinical success rate was 92.3%. The mean survival period after stent placement was 103 d. The mean period of stent patency was 149 d and the patency remained acceptable for the survival period. Stent dysfunction occurred in 3 patients (7.7%) on account of tumor growth.

Conclusion: Endoscopic management using duodenal stents for patients with incurable malignant gastric outlet obstruction is safe and improved patients' quality of life.

Keywords: Duodenal stenosis; Gastric stenosis; Gastrointestinal stent; Malignant tumors; Metallic stent.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alloys*
  • Digestive System Neoplasms / complications*
  • Duodenoscopes
  • Duodenoscopy / adverse effects
  • Duodenoscopy / instrumentation*
  • Female
  • Gastric Outlet Obstruction / diagnostic imaging
  • Gastric Outlet Obstruction / etiology
  • Gastric Outlet Obstruction / therapy*
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Prospective Studies
  • Prosthesis Design
  • Stents*
  • Time Factors
  • Treatment Outcome

Substances

  • Alloys
  • nitinol