Treatment of gastric outlet and duodenal obstructions with uncovered expandable metal stents.
OBJECTIVE
To investigate and evaluate the technical feasibility and clinical effectiveness of fluoroscopically guided peroral uncovered expandable metal stent placement to treat gastric outlet and duodenal obstructions.


METHODS
Fifteen consecutive patients underwent peroral placement of Wallstent(TM) Enteral Endoprosthesis to treat gastric outlet and duodenal obstructions (14 malignant, 1 benign). All procedures were completed under fluoroscopic guidance without endoscopic assistance. Follow-up was completed until the patients died or were lost, and the clinical outcomes were analyzed.


RESULTS
The technique success rate was 100%, and the oral intake was maintained in 12 of 14 patients varying from 7 d to 270 d. Two patients remained unable to resume oral intake, although their stents were proven to be patent with the barium study. One patient with acute necrotizing pancreatitis underwent enteral stenting to treat intestinal obstruction, and nausea and vomiting disappeared. Ten patients died during the follow-up period, and their mean oral intake time was 50 d. No procedure-related complications occurred. Stent migration to the gastric antrum occurred in one patient 1 year after the procedure, a tumor grew at the proximal end of the stent in another patient 38 d post-stent insertion.


CONCLUSIONS
Fluoroscopically guided peroral metal stent implantation is a safe and effective method to treat malignant gastrointestinal obstructions, and complications can be ignored based on our short-term study. Indications for this procedure should be discreetly considered because a few patients may not benefit from gastrointestinal insertion, but some benign gastrointestinal obstructions can be treated using this procedure.
Huang
Qiang
Q
Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100021, China.
Dai
Ding-Ke
DK
Qian
Xiao-Jun
XJ
Zhai
Ren-You
RY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004380:Duodenal Obstruction / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects / Q000379:methods; D017219:Gastric Outlet Obstruction / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome