Malignant duodenal obstructions: palliative treatment using self-expandable nitinol stents.
OBJECTIVE
To assess the efficacy of fluoroscopic per oral placement of self-expandable nitinol stents in the palliative treatment of malignant duodenal obstructions.


METHODS
Under fluoroscopic guidance, 82 patients (56 male and 26 female; mean age, 62.3 y) with malignant duodenal obstructions were treated with per oral placement of four types of self-expandable nitinol stents. All patients presented with severe nausea and recurrent vomiting, and their obstructions were inoperable.


RESULTS
Technical success was achieved in 78 of 82 patients (95.1%). After stent placement, food intake capacity improved in 74 of 78 patients (94.9%). Stent migration occurred in one patient 4 days after placement. A covered stent was placed to cover the ampulla of Vater in 15 patients without external biliary drainage; three of them (20%) became jaundiced. During the mean follow-up period of 74.7 days (range, 9-374 d), eight patients developed recurrent obstructive symptoms caused by tumor ingrowth (n=2) or tumor overgrowth (n=6). They were successfully treated by additional stent placement. The primary stent patency rates were 97.0%, 79.8%, and 44.0% at 30-, 90-, and 180 days, respectively (mean patency, 228.2 d; 95% CI, 153.9-302.5).


CONCLUSIONS
Fluoroscopic per oral placement of self-expandable nitinol stents is an effective palliative treatment for malignant duodenal obstructions.
Yoon
Chang Jin
CJ
Department of Radiology, Seoul National University Bundang Hospital, SeongNam, Republic of Korea.
Song
Ho-Young
HY
Shin
Ji Hoon
JH
Bae
Jae-Ik
JI
Jung
Gyoo-Sik
GS
Kichikawa
Kimihiko
K
Lopera
Jorge E
JE
Castaneda-Zuniga
Wilfrido
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D004379:Duodenal Neoplasms / Q000473:pathology / Q000628:therapy*; D004380:Duodenal Obstruction / Q000473:pathology / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000628:therapy*; D015641:Radiography, Interventional; D015607:Stents
D000497:Alloys; C013616:nitinol