title: Comparison between uncovered and covered self-expandable metal stent placement in malignant duodenal obstruction.
abstract: OBJECTIVE
  To compare the clinical outcomes of uncovered and covered self-expandable metal stent placements in patients with malignant duodenal obstruction.
  
  
  METHODS
  A total of 67 patients were retrospectively enrolled from January 2003 to June 2013. All patients had symptomatic obstruction characterized by nausea, vomiting, reduced oral intake, and weight loss. The exclusion criteria included asymptomatic duodenal obstruction, perforation or peritonitis, concomitant small bowel obstruction, or duodenal obstruction caused by benign strictures. The technical and clinical success rate, complication rate, and stent patency were compared according to the placement of uncovered (n = 38) or covered (n = 29) stents.
  
  
  RESULTS
  The technical and clinical success rates did not differ between the uncovered and covered stent groups (100% vs 96.6% and 89.5% vs 82.8%). There were no differences in the overall complication rates between the uncovered and covered stent groups (31.6% vs 41.4%). However, stent migration occurred more frequently with covered than uncovered stents [20.7% (6/29) vs 0% (0/38), P < 0.05]. Moreover, the overall cumulative median duration of stent patency was longer in uncovered than in covered stents [251 d (95%CI: 149.8 d-352.2 d) vs 139 d (95%CI: 45.5 d-232.5 d), P < 0.05 by log-rank test] The overall cumulative median survival period was not different between the uncovered stent (70 d) and covered stent groups (60 d).
  
  
  CONCLUSIONS
  Uncovered stents may be preferable in malignant duodenal obstruction because of their greater resistance to stent migration and longer stent patency than covered stents.
authors: Ji Won Kim, Ji Bong Jeong, Kook Lae Lee, Byeong Gwan Kim, Dong Won Ahn, Jae Kyung Lee, Su Hwan Kim, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul 156-707, South Korea.
authors: Ji Won
authors: JW
authors: Kim
authors: Ji Won Kim, Ji Bong Jeong, Kook Lae Lee, Byeong Gwan Kim, Dong Won Ahn, Jae Kyung Lee, Su Hwan Kim, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul 156-707, South Korea.
authors: Ji Bong
authors: JB
authors: Jeong
authors: Ji Won Kim, Ji Bong Jeong, Kook Lae Lee, Byeong Gwan Kim, Dong Won Ahn, Jae Kyung Lee, Su Hwan Kim, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul 156-707, South Korea.
authors: Kook Lae
authors: KL
authors: Lee
authors: Ji Won Kim, Ji Bong Jeong, Kook Lae Lee, Byeong Gwan Kim, Dong Won Ahn, Jae Kyung Lee, Su Hwan Kim, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul 156-707, South Korea.
authors: Byeong Gwan
authors: BG
authors: Kim
authors: Ji Won Kim, Ji Bong Jeong, Kook Lae Lee, Byeong Gwan Kim, Dong Won Ahn, Jae Kyung Lee, Su Hwan Kim, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul 156-707, South Korea.
authors: Dong Won
authors: DW
authors: Ahn
authors: Ji Won Kim, Ji Bong Jeong, Kook Lae Lee, Byeong Gwan Kim, Dong Won Ahn, Jae Kyung Lee, Su Hwan Kim, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul 156-707, South Korea.
authors: Jae Kyung
authors: JK
authors: Lee
authors: Ji Won Kim, Ji Bong Jeong, Kook Lae Lee, Byeong Gwan Kim, Dong Won Ahn, Jae Kyung Lee, Su Hwan Kim, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul 156-707, South Korea.
authors: Su Hwan
authors: SH
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004380:Duodenal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D004384:Duodenoscopy / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000401:mortality; D010166:Palliative Care; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D008670:Metals
keywords: Duodenal obstruction; Gastric outlet obstruction; Neoplasms; Palliative treatment; Stents