title: Treatment of malignant gastroduodenal obstruction with a nitinol self-expanding metal stent: an international prospective multicentre registry.
abstract: BACKGROUND
  Duodenal stenting has become a broadly accepted first line of treatment for patients with advanced malignant gastroduodenal obstruction as these patients are difficult to treat and are poor surgical candidates.
  
  
  OBJECTIVE
  To document duodenal stent performance for palliative management of malignant gastroduodenal obstruction.
  
  
  METHODS
  Multicentre, single arm, prospective registry documenting peroral endoscopic duodenal stenting procedures in 202 patients.
  
  
  RESULTS
  Technical success achieved in 98% (CI, 95%, 99%) of stent placements. Increase of Gastric Outlet Obstruction Score by at least 1 point compared to baseline was achieved in 91% (CI, 86%, 95%) of patients persisting for a median of 184 days (CI, 109, 266). By day 5 (CI, 4, 6) after stent placement, 50% of patients experienced a score increase of at least 1 point. Improvement from 14% of patients at baseline tolerating soft solids or low residue/normal diet to 84% at 15 days, 86% at 30 days, 81% at 90 days, 79% at 180 days, and 70% at 270 days. Complications included stent ingrowth and/or overgrowth (12.4%), transient periprocedural symptoms (3%), bleeding (3%), stent migration (1.5%), and perforation (0.5%).
  
  
  CONCLUSIONS
  Safety and effectiveness of duodenal stenting for palliation of malignant gastroduodenal obstruction was confirmed in the largest international prospective series to date.
authors.affiliation: Policlinico A. Gemelli, Rome, Italy. gcostamagna@rm.unicatt.it
authors.forename: Guido
authors.initials: G
authors.lastname: Costamagna
authors.forename: Andrea
authors.initials: A
authors.lastname: Tringali
authors.forename: Julius
authors.initials: J
authors.lastname: Spicak
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mutignani
authors.forename: John
authors.initials: J
authors.lastname: Shaw
authors.forename: Andre
authors.initials: A
authors.lastname: Roy
authors.forename: Erik
authors.initials: E
authors.lastname: Johnsson
authors.forename: Eduardo G H
authors.initials: EG
authors.lastname: De Moura
authors.forename: Spencer
authors.initials: S
authors.lastname: Cheng
authors.forename: Thierry
authors.initials: T
authors.lastname: Ponchon
authors.forename: Max
authors.initials: M
authors.lastname: Bittinger
authors.forename: Helmut
authors.initials: H
authors.lastname: Messmann
authors.forename: Horst
authors.initials: H
authors.lastname: Neuhaus
authors.forename: Brigitte
authors.initials: B
authors.lastname: Schumacher
authors.forename: Rene
authors.initials: R
authors.lastname: Laugier
authors.forename: Juha
authors.initials: J
authors.lastname: Saarnio
authors.forename: Francisco Igea
authors.initials: FI
authors.lastname: Ariqueta
mesh_terms: D000497:Alloys; D004380:Duodenal Obstruction / Q000209:etiology / Q000628:therapy*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000628:therapy*; D005770:Gastrointestinal Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D015607:Stents / Q000009:adverse effects*; D016019:Survival Analysis
chemical_list: D000497:Alloys; C013616:nitinol