Gastric emptying in patients with palliative stenting for malignant gastric outlet obstruction.
OBJECTIVE
Palliative stenting for gastric outlet obstruction (GOO) offers a more rapid resumption of oral intake than surgical gastrojejunostomy. Clinically, delayed gastric emptying is observed less frequently in patients with enteral stenting. The aim of this study was to conduct a functional assessment of gastric emptying after stent placement for GOO using isotope scanning.


METHODS
Gastric emptying was assessed in 14 patients with GOO (4 female, 10 male; mean age 67.9 years; 8 with gastric cancer; 4 with pancreatic cancer; 1 with biliary cancer; 1 with metastasis) and 10 healthy volunteers (2 female, 8 male; mean age 31.5 years). None of the patients had undergone previous stomach surgery. The patients were studied 1 week after stent placement. Scintigraphy was performed for 2 hours following the ingestion of a labeled liquid meal. Gastric retention was evaluated at 2 hours in both groups.


RESULTS
All patients underwent successful placement of stents and were able to resume an oral diet. All stents were fully deployed and no migration was seen at the time of the investigation. Retained gastric activity at 120 minutes (RGA120) was significantly greater in patients than in controls (65.4% vs. 27.5%, p=0.0128). Median survival time was 179 days in patients with T1/2 of 120 min or less and 75 days in patients with T1/2 of over 120 min.


CONCLUSIONS
The results of our study show that although patients with GOO have resumed oral intake 1 week after stent placement, restoration of gastric emptying is often still incomplete.
Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan. maet@oha.toho-u.ac.jp
Iruru
I
Maetani
Takeo
T
Ukita
Tomoko
T
Tada
Masaki
M
Ikeda
Masahiro
M
Seike
Hitoshi
H
Terada
Ehichi
E
Kohda
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000150:complications; D018450:Disease Progression; D005260:Female; D005746:Gastric Emptying; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D018589:Gastroparesis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications