title: Additional gastroduodenal stent placement: retrospective evaluation of 68 consecutive patients with malignant gastroduodenal obstruction.
abstract: BACKGROUND
  Self-expandable metallic stent placement is widely used to manage malignant gastroduodenal obstructions. However, the techniques and effectiveness of additional gastroduodenal stent placement have not been evaluated until now.
  
  
  OBJECTIVE
  To evaluate the technical feasibility, clinical effectiveness, and complications of additional gastroduodenal stent placement in patients with recurrent obstructive symptoms after primary gastroduodenal stenting.
  
  
  METHODS
  We retrospectively analyzed data from 68 consecutive patients who had additional gastroduodenal stents placed for recurrent obstruction. Clinical effectiveness was assessed using technical and clinical success rates, gastric outlet obstruction score improvement after primary and additional stent placement, and complications.
  
  
  RESULTS
  Additional stent placement was technically successful in 66 of the 68 patients (97%) and symptomatic improvement was achieved in 58 (85%). The gastric outlet obstruction score improved after primary stent placement (0.3 to 1.4) and additional stent placement (0.2 to 1.4). Complications occurred in 12 of 68 patients (18%) and were caused by tumor overgrowth (n = 7), stent collapse (n = 2), food impaction (n = 1), jaundice (n = 1), and duodenal perforation (n = 1).
  
  
  CONCLUSIONS
  Additional gastroduodenal stent placement is technically feasible and clinically effective for patients with recurrent gastric outlet obstruction after stent placement.
authors.affiliation: Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Min Kyoung
authors.initials: MK
authors.lastname: Kang
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Kim
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kim
authors.forename: Jung-Hoon
authors.initials: JH
authors.lastname: Park
authors.forename: Han Kyu
authors.initials: HK
authors.lastname: Na
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Lee
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004380:Duodenal Obstruction / Q000209:etiology / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000601:surgery*; D005770:Gastrointestinal Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Malignant gastroduodenal obstruction; additional stent placement; self-expandable metallic stent