Malignant gastric and duodenal stenosis: palliation by peroral implantation of a self-expanding metallic stent.
OBJECTIVE
To assess the use of self-expanding metallic stents in patients with inoperable malignant antrum-pylorus-duodenal obstruction.


METHODS
Six patients underwent implantation of a Wallstent self-expanding metallic endoprosthesis (20 mm in five patients and 16 mm in one). In five patients a catheter (Berenstein) was introduced perorally into the stomach. A guidewire (Terumo) was introduced through the catheter and advanced through the antrum-pylorus-duodenal stenosis. The guidewire was removed and a 260-cm-long, 0.035" superstiff guide (Amplatz) was introduced. After the catheter was removed the stent assembly was introduced. In the last patient the stent was implanted through a percutaneous gastrostomy.


RESULTS
Treatment of inoperable gastric outlet obstruction caused by tumor compression is difficult and unsatisfactory. Peroral implantation of self-expanding metallic stents resulted in successful palliative therapy of antrum-pylorus-duodenal stenosis in six patients in whom surgery was not possible because of advanced disease and poor general condition. On average, patients were able to eat during 41 days. One patient is tolerating oral intake at 3 months.


CONCLUSIONS
Implantation of stents resulted in palliative relief of malignant antrum-pylorus-duodenal obstructions.
Pinto
I T
IT
Department of Radiology, Hospital Universitario de Getafe, Ctra. de Toledo, Km. 12.5, E-28905 Getafe, Madrid, Spain.
D000368:Aged; D000369:Aged, 80 and over; D004379:Duodenal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D004380:Duodenal Obstruction / Q000000981:diagnostic imaging / Q000628:therapy*; D004384:Duodenoscopy; D005260:Female; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011859:Radiography; D015607:Stents; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D016896:Treatment Outcome