Expandable metallic prostheses for malignant obstructions of gastric outlet and proximal small bowel.
BACKGROUND
Data are limited on use of expandable metal stents for treatment of malignant gastric outlet obstruction. Accordingly, we report our experience using these stents to palliate malignant obstructions of the gastric outlet, duodenum, and proximal jejunum.


METHODS
Eight patients with malignant strictures causing gastric obstruction underwent endoscopy with fluoroscopic guidance to delineate tumor borders and length followed by expandable metallic prosthesis placement (Wallstent, Z-Stent, Ultraflex, and Endocoil).


RESULTS
Symptoms were relieved in seven patients, five of whom had previous surgeries (Whipple, Billroth II, esophagojejunostomy, and gastrojejunostomy) for malignancy. One patient underwent surgical resection of a presumed malignant stricture containing a previously placed Wallstent after a 45-pound weight gain.


CONCLUSIONS
Expandable metallic prostheses placed in patients with malignant obstruction of the gastric outlet, duodenum, or proximal jejunum, before or after surgery, effectively palliate obstructive symptoms and may also serve to improve nutrition.
Nevitt
A W
AW
Department of Radiology, Virginia Mason Medical Center, Seattle, Washington 98111, USA.
Vida
F
F
Kozarek
R A
RA
Traverso
L W
LW
Raltz
S L
SL
D000368:Aged; D000369:Aged, 80 and over; D004380:Duodenal Obstruction / Q000209:etiology / Q000628:therapy; D016099:Endoscopy, Gastrointestinal; D004867:Equipment Design; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000628:therapy*; D007579:Jejunal Diseases / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D010166:Palliative Care / Q000379:methods*; D015607:Stents; D016896:Treatment Outcome