title: Endoscopic management of unresectable malignant gastroduodenal obstruction with a nitinol uncovered metal stent: A prospective Japanese multicenter study.
abstract: OBJECTIVE
  To determine the safety and efficacy of endoscopic duodenal stent placement in patients with malignant gastric outlet obstruction.
  
  
  METHODS
  This prospective, observational, multicenter study included 39 consecutive patients with malignant gastric outlet obstruction. All patients underwent endoscopic placement of a nitinol, uncovered, self-expandable metal stent. The primary outcome was clinical success at 2 wk after stent placement that was defined as improvement in the Gastric Outlet Obstruction Scoring System score relative to the baseline.
  
  
  RESULTS
  Technical success was achieved in all duodenal stent procedures. Procedure-related complications occurred in 4 patients (10.3%) in the form of mild pneumonitis. No other morbidities or mortalities were observed. The clinical success rate was 92.3%. The mean survival period after stent placement was 103 d. The mean period of stent patency was 149 d and the patency remained acceptable for the survival period. Stent dysfunction occurred in 3 patients (7.7%) on account of tumor growth.
  
  
  CONCLUSIONS
  Endoscopic management using duodenal stents for patients with incurable malignant gastric outlet obstruction is safe and improved patients' quality of life.
authors.affiliation: Reina Sasaki, Yuji Sakai, Toshio Tsuyuguchi, Takao Nishikawa, Harutoshi Sugiyama, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
authors.forename: Reina
authors.initials: R
authors.lastname: Sasaki
authors.affiliation: Reina Sasaki, Yuji Sakai, Toshio Tsuyuguchi, Takao Nishikawa, Harutoshi Sugiyama, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sakai
authors.affiliation: Reina Sasaki, Yuji Sakai, Toshio Tsuyuguchi, Takao Nishikawa, Harutoshi Sugiyama, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Tsuyuguchi
authors.affiliation: Reina Sasaki, Yuji Sakai, Toshio Tsuyuguchi, Takao Nishikawa, Harutoshi Sugiyama, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Nishikawa
authors.affiliation: Reina Sasaki, Yuji Sakai, Toshio Tsuyuguchi, Takao Nishikawa, Harutoshi Sugiyama, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Fujimoto
authors.affiliation: Reina Sasaki, Yuji Sakai, Toshio Tsuyuguchi, Takao Nishikawa, Harutoshi Sugiyama, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Mikami
authors.affiliation: Reina Sasaki, Yuji Sakai, Toshio Tsuyuguchi, Takao Nishikawa, Harutoshi Sugiyama, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
authors.forename: Harutoshi
authors.initials: H
authors.lastname: Sugiyama
authors.affiliation: Reina Sasaki, Yuji Sakai, Toshio Tsuyuguchi, Takao Nishikawa, Harutoshi Sugiyama, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D004067:Digestive System Neoplasms / Q000150:complications*; D020698:Duodenoscopes; D004384:Duodenoscopy / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D017219:Gastric Outlet Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000497:Alloys; C013616:nitinol
keywords: Duodenal stenosis; Gastric stenosis; Gastrointestinal stent; Malignant tumors; Metallic stent