Malignant obstruction of gastric outlet and duodenum: palliation with flexible covered metallic stents.
OBJECTIVE
To assess the usefulness of flexible covered metallic stents in the palliation of malignant obstruction of the gastric outlet and duodenum.


METHODS
Twenty-four consecutive patients with malignant obstruction of the gastric outlet (n = 22) or duodenum (n = 2) underwent palliative treatment with self-expandable flexible covered metallic stents. Fourteen patients had advanced gastric carcinoma at the antrum and/or pylorus, and eight had obstruction at the anastomosis site of previous gastrojejunostomy. Complications and clinical status were investigated during the study period.


RESULTS
The technical success rate was 75% (18 of 24 patients). Twenty-one stents were placed in 18 patients by using an introducer 6 (n = 7) or 8 mm (n = 14) in diameter. The mean follow-up period was 3.4 months (range, 1 week to 9 months). Symptoms improved in 12 (67%) patients after the procedure. There was no change in symptoms in five and a decrease in one. Twelve patients died during the follow-up period (mean survival, 4.3 months). The complication rate was 25% (six of 24 patients), including stent migration (n = 5) and fracture (n = 3).


CONCLUSIONS
Flexible covered metallic stent placement can be useful for palliation in patients with malignant obstruction of the gastric outlet or duodenum.
Park
K B
KB
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, Korea.
Do
Y S
YS
Kang
W K
WK
Choo
S W
SW
Han
Y H
YH
Suh
S W
SW
Lee
S J
SJ
Park
K S
KS
Choo
I W
IW
D000328:Adult; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D004380:Duodenal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods*; D011859:Radiography; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications; D013997:Time Factors