title: Malignant pyloro-duodenal obstruction: role of self expandable metallic stents.
abstract: OBJECTIVE
  To determine the outcome of duodenal stenting in palliation of patients with malignant pyloric and duodenal obstruction.
  
  
  METHODS
  The non-randomised prospective descriptive study was conducted at the Endoscopy Suite, Surgical Unit-IV, Civil Hospital, Karachi, from December 2007 to November 2010. All patients presenting with inoperable ampullary, pancreatic or biliary cancers causing duodenal obstruction and patients with resectable malignancy but unfit for surgery were included. The procedure was carried out by a single expert endoscopist under local or general anaesthaesia as required. Boston Scientific stents of variable sizes were used. Follow-up was done at 1 week, 1 month and 6 months. Data analysis was done using SPSS 15.
  
  
  RESULTS
  Over the study period, 159 (60%) males and 6 (40%) females were included in the study. The male-to-female ratio was 2:3. The overall age ranged from 25-80 years with a mean of 52.67 +/- 15.07 years. Primary diagnosis was pyloric carcinoma in 7(46.6%), carcinoma Gallbladder in 4(26.6%), Duodenal carcinoma in 3(20%) and carcinoma head of pancreas in 1(6.6%). Relief of symptoms were seen in 11 (73.3%), while complications were seen in 2 (13.3%). Stents were inserted with technical success in 14 (93%) patients. Clinical success was seen in 11 (73%), with a mean survival of 74.27 +/- 40.7 days (range: 15-180 days). No statistical significance was found when comparing the survival time with age, gender and diagnosis.
  
  
  CONCLUSIONS
  Use of self-expandable metallic stents for gastroduodenal malignancies appears to be a feasible, safe and effective method, especially in those patients with limited life expectancy.
authors.affiliation: Department of Surgey, DUHS and Civil Hospital Karachi. sajida_q@yahoo.com
authors.forename: Sajida
authors.initials: S
authors.lastname: Qureshi
authors.affiliation: Department of Surgey, DUHS and Civil Hospital Karachi.
authors.forename: Shahriyar
authors.initials: S
authors.lastname: Ghazanfar
authors.affiliation: Department of Surgery, Shaukat Khanum Hospital.
authors.forename: Abu Bakar
authors.initials: AB
authors.lastname: Hafeez
authors.affiliation: Deaptment of Medicine, Indus Hospital, Karachi.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Taj
authors.affiliation: Department of Gastroengerology, Civil Hospital Karachi.
authors.forename: Saad Khalid
authors.initials: SK
authors.lastname: Niaz
authors.affiliation: Department of Surgey, DUHS and Civil Hospital Karachi.
authors.forename: Mohammad Saeed
authors.initials: MS
authors.lastname: Quraishy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000150:complications; D004067:Digestive System Neoplasms / Q000150:complications*; D004380:Duodenal Obstruction / Q000209:etiology / Q000628:therapy*; D005260:Female; D005706:Gallbladder Neoplasms / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications; D011446:Prospective Studies; D011708:Pylorus; D015607:Stents