Self-expandable metal stents in the treatment of antro-pyloric and/or duodenal strictures.
OBJECTIVE
To assess the usefulness of self-expandable metal stents in the recanalization of antro-pyloric and/or duodenal strictures.


METHODS
We report our experience of 15 patients with inoperable antro-pyloric and/or duodenal strictures treated by implantation of 21 self-expandable metal stents (18 uncovered and 3 covered) inserted perorally under fluoroscopic guidance. The patients were 11 men and 4 women, mean age 65.3 years. Fourteen of 15 patients were affected by a malignant stricture of the antro-pyloric region and/or duodenum either primary or secondary in 10 and 4 cases, respectively. Only in 1 case there was a benign stricture from postoperative scarring. Stricture length and diameter varied from 3 to 9 cm (mean 5.4 cm) and from 0 to 4 mm (mean 1.27 mm), respectively.


RESULTS
Twenty-one stents were placed in 15 patients: Technical success was achieved in all cases while clinical improvement was obtained in 14 cases. No short-term complications were observed. A mean 4.3-month follow-up was obtained. Two patients had emesis secondary to peritoneal dissemination of the tumor after 1 and 2 months, respectively. Two other patients showed tumor overgrowth of the oral edge of the prosthesis after 3 and 2 months, respectively, and required another coaxial stent to bridge the new stenosis. The patient treated for a benign stricture had jaundice after 3 months and percutaneous internal-external biliary drainage was necessary.


CONCLUSIONS
Self-expandable metal stents are a safe and effective treatment of antro-pyloric and duodenal strictures; therefore, they should be considered an alternative to palliative resection in cases of advanced stage disease or poor general physical condition.
Profili
S
S
Department of Radiology, University of Sassari, Sassari, Italy.
Meloni
G B
GB
Bifulco
V
V
Conti
M
M
Feo
C F
CF
Canalis
G C
GC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic; D004067:Digestive System Neoplasms / Q000150:complications; D004378:Duodenal Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum; D011707:Pyloric Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D015607:Stents