title: WallFlex™ Duodenal Stent Placement in a Gastric Cancer Patient with Malignant Stenosis of a Roux-en-Y Gastrojejunostomy following Distal Gastrectomy.
abstract: A 69-year-old Japanese woman with a history of distal gastrectomy with a Roux-en-Y reconstruction for advanced gastric cancer was admitted to our hospital complaining of severe dysphagia. On admission, the patient was only able to take liquids, and a firm, fist-sized tumor was palpable in her left upper abdomen. An endoscopic examination disclosed stenosis of the jejunal limb of the gastrojejunostomy. Abdominal computed tomography revealed that a recurrent tumor, 5.0 cm in diameter, was compressing the jejunal limb of the gastrojejunostomy. A knitted nitinol self-expandable metallic stent (WallFlex™ duodenal stent) was placed endoscopically at the stenotic jejunum from the gastrojejunostomy. The time required for stenting and total endoscopic manipulation was 12 and 35 minutes, respectively. No stent-related complications were observed. The patient could resume oral ingestion 1 day after endoscopic stenting and was discharged on the fifth day after treatment. She survived for 201 days after stenting. She continued oral ingestion for 194 days and stayed at home for 165 days. The WallFlex duodenal stent allows safe endoscopic stenting, even in cases of malignant stenosis of a gastrojejunostomy following distal gastrectomy. This stenting device will extend the indications for endoscopic palliation of gastric cancer patients with gastric outlet stenosis.
authors.affiliation: Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kakuta
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Yajima
authors.forename: Seiji
authors.initials: S
authors.lastname: Kayama
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tsuno
authors.forename: Keita
authors.initials: K
authors.lastname: Saito
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Kosugi
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kanda
keywords: Gastric cancer; Recurrence; Roux-en-Y gastrojejunostomy; WallFlex™ duodenal stent