Role of endoscopic stenting in the duodenum.
BACKGROUND
Gastric outlet obstruction may cause the presenting symptoms, or may develop during the course of pancreatic or biliary malignancy. Treatment options for malignant gastric outlet obstruction are limited. Surgical gastrojejunostomy is commonly performed, but carries significant morbidity and mortality.


METHODS
Over the past two years, we conducted a prospective study to determine the safety, feasibility and outcomes of the newly-designed Wallstent Enteral (Scneider, Minneapolis, MN) to treat a variety of malignant gastric outlet obstructions. We deployed stents 16 to 22 mm in diameter and 60 to 90 mm in length directly through the endoscope.


RESULTS
Twelve patients (10 women ans 2 men, mean age = 59.7 years) underwent the procedure. After stenting, six patients were able to eat a regular diet, and three were able to eat a pureed diet. In three patients, the procedure was unsuccessful because of multiple obstructions that were not recognized prior to stenting in one and stents that were deployed either too proximally in one or too distally in another. Three patients were discharged within 24 hours after stenting and three had the procedure as an outpatient.


CONCLUSIONS
Placement of the Wallstent Enteral through the endoscope is safe and effective palliation for a variety of malignant gastric outlet obstructions, and leads to significant improvement in many aspects of patients' quality of life.
Carr-Locke
D L
DL
Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D004378:Duodenal Diseases / Q000628:therapy*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents