Gastric and duodenal stents: follow-up and complications.
OBJECTIVE
To assess the efficacy of self-expanding metallic stents in treating inoperable gastric and duodenal stenoses during follow-up and to evaluate the complications encountered.


METHODS
A total of 31 patients suffering from gastroduodenal obstruction (29 malignant, 2 benign) were treated with a self-expanding metallic stent (Wallstent). In 24 cases insertion was by the peroral route, in seven cases via gastrostomy.


RESULTS
All the strictures were successfully negotiated under fluoroscopic guidance without having to resort to endoscopy. A total of 27 patients (87%) were able to resume a regular diet, a soft diet, or a liquid diet orally. Complications included one case of stent malpositioning, one case of leakage of ascitic fluid through the gastrostomy orifice, one case of perforation and fistula to the biliary tree, and two cases of hematemesis. In two patients (6%) additional stents were implanted to improve patency. In all patients follow-up was maintained until death. Recurrence of symptoms immediately before death occurred in seven cases (23%). Mean survival time of patients was 13.3 weeks (SE +/- 4.6).


CONCLUSIONS
The deployment of gastroduodenal stents resulted in good palliation of inoperable gastric and duodenal stenoses. Certain technical aspects, e.g., adaptation of stents to bowel morphology, is critical to proper stent function and avoidance of complications.
Pinto Pabón
I T
IT
Vascular and Interventional Radiology Department, Hospital Universitario de Getafe, Ctra de Toledo km. 12,500, E-28905 Getafe, Madrid, Spain. isabelpinto@retemail.es
Díaz
L P
LP
Ruiz De Adana
J C
JC
López Herrero
J
J
D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000601:surgery; D004380:Duodenal Obstruction / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011859:Radiography; D015607:Stents / Q000009:adverse effects*