title: Endoscopic metal stents for the palliation of malignant upper gastroduodenal obstruction.
abstract: OBJECTIVE
  Gastric outlet obstruction (GOO) is frequently caused by tumor. Recently, endoscopic implantation of self-expanding metallic stents (SEMS) has been introduced as an improved palliative treatment for GOO. This study aims to study the effect of SEMS placement on nutrient intake in patients with GOO and correlate different SEMS positions with postoperative clinical outcomes.
  
  
  METHODS
  Fifty six non-operable patients with GOO were enrolled. Obstruction of the duodenum (n=23) or gastric outlet (n=33) were commonly found. Either Wallstent Enteral Stents, WallFlex Enteral Duodenal or partially covered Ultraflex esophageal stents were placed under endoscopic and fluoroscopic guidance. The Gastric Outlet Obstruction Score (GOOSS) was used as the main outcome measurement.
  
  
  RESULTS
  The procedure was technically feasible in 100% of patients and gave satisfactory clinical results in 98.2% (55/56). The patients had a median survival time of 97.5 days (range 9-380). Median stent patency was 72 days with a range of 8 to 267 days. The average GOOSS, measuring oral intake, was significantly improved, regardless of obstruction site (p<0.05). We also found that the site of SEMS placement did not affect the clinical outcome.
  
  
  CONCLUSIONS
  Palliation with SEMS is a safe and effective method for restoring gastric intake in patients with malignant GOO.
authors.affiliation: Department of Gastroenterology and Hepatology, Chang Gung Memotial Hospital, Linkou, Tao-Yuan, Taiwan.
authors.forename: Hao-Tsai
authors.initials: HT
authors.lastname: Cheng
authors.forename: Yung-Kuan
authors.initials: YK
authors.lastname: Tsou
authors.forename: Cheng-Hui
authors.initials: CH
authors.lastname: Lin
authors.forename: Chi-Liang
authors.initials: CL
authors.lastname: Cheng
authors.forename: Jui-Hsiang
authors.initials: JH
authors.lastname: Tang
authors.forename: Ching-Song
authors.initials: CS
authors.lastname: Lee
authors.forename: Kai-Feng
authors.initials: KF
authors.lastname: Sung
authors.forename: Mu-Hsien
authors.initials: MH
authors.lastname: Lee
authors.forename: Jau-Min
authors.initials: JM
authors.lastname: Len
authors.forename: Yin-Yi
authors.initials: YY
authors.lastname: Chu
authors.forename: Ming-Hung
authors.initials: MH
authors.lastname: Tsai
authors.forename: Nai-Jen
authors.initials: NJ
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005746:Gastric Emptying; D017219:Gastric Outlet Obstruction / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents
chemical_list: D008670:Metals