Malignant gastroduodenal obstruction: treatment with self-expanding uncovered wallstent.
OBJECTIVE
To retrospectively evaluate the clinical effectiveness of a self-expanding uncovered Wallstent in patients with malignant gastroduodenal obstruction.


METHODS
Under combined endoscopic and fluoroscopic guidance, 29 patients with a malignant gastroduodenal stenosis were treated with a self-expanding uncovered metallic Wallstent. A dysphagia score was assessed before and after the intervention to measure the success of this palliative therapy. The dysphagia score ranged between grade 0 to grade 4: grade 0 = able to tolerate solid food, grade 1 = able to tolerate soft food, grade 2 = able to tolerate thick liquids, grade 3 = able to tolerate water or clear fluids, and grade 4 = unable to tolerate anything perorally. Stent patency and patients survival rates were calculated.


RESULTS
The insertion of the gastroduodenal stent was technically successful in 28 patients (96.5%). After stenting, 25 patients (86.2%) showed clinical improvement by at least one score point. During follow-up, 22 (78.5%) of 28 patients showed no stent occlusion until death and did not have to undergo any further intervention. In six patients (20.6%), all of whom were treated with secondary stent insertions, occlusion with tumor ingrowth and/or overgrowth was observed after the intervention. The median period of primary stent patency in our study was 240 days.


CONCLUSIONS
Placement of an uncovered Wallstent is clinically effective in patients with malignant gastroduodenal obstruction. Stent placement is associated with high technical success, good palliation effect, and high durability of stent function.
Gutzeit
Andreas
A
Department of Radiology, Kantonsspital Winterthur, Winterthur, Switzerland. Andreas.Gutzeit@ksw.ch
Binkert
Christoph A
CA
Schoch
Eric
E
Sautter
Thomas
T
Jost
Res
R
Zollikofer
Christoph L
CL
D000008:Abdominal Neoplasms / Q000150:complications*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004380:Duodenal Obstruction / Q000209:etiology / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000628:therapy*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate