Self-expanding duodenal stents, palliative treatment of gastric outlet obstruction in malignant disease

Czech version

Authors: J. Ušák ¹; F. Závada ^1,2; R. Husťak ^1,3; A. Klepanec ⁴; I. Keher ⁵; S. Hojerová ⁶; M. Streško ⁷; V. Ušáková ⁸; J. Martínek ^1,9
Authors‘ workplace: Gastroenterologická a endoskopická ambulancia, Interná klinika FZaSP TU a FN Trnava ¹; Gastroenterologie, Oblastní nemocnice Příbram, a. s. ²; Katedra laboratórnych vyšetrovacích metód v zdravotníctve, FZaSP TU v Trnave ³; Rádiologická klinika FZaSP TU a FN Trnava ⁴; Chirurgická klinika FZaSP TU a FN Trnava ⁵; Interná klinika FZaSP TU a FN Trnava ⁶; Onkologická klinika FZaSP TU a FN Trnava 8 Onkologický ústav sv. Alžbety, s. r. o., Bratislava ⁷; Klinika hepatogastroenterologie, Transplantcentrum, IKEM, Praha ⁹
Published in: Gastroent Hepatol 2018; 72(5): 408-414
Category: Gastrointestinal Oncology: Original Article
doi: https://doi.org/10.14735/amgh2018408

Overview

Background:

Endoscopic self-expandable metallic stent (SEMS) placement for gastric outlet obstruction caused by either intrinsic or extrinsic obstruction of the pylorus or duodenum is an elective palliative procedure for high-risk surgical patients. Pancreatic and/or gastric carcinoma are often diagnosed at an advanced stage when the incidence of poor nutritional status is high and SEMS placement has the potential of providing the best supportive care.

Aim:

To evaluate our first experience with SEMS for palliation of malignant gastric outlet obstruction measured by gastric outlet obstruction score and to assess the survival rate of patients undergoing this treatment.

Method:

Retrospective analysis was performed at a tertiary center between 2013 and 2017 to assess overall patient survival after SEMS placement that allowed patients to the leave hospital quickly and return to daily activity. The mean age of the patients was 69.5 years. Twenty-six duodenal stents were implanted in 20 patients, who had been diagnosed with pancreatic and gastric cancer with a low performance status, making them unfit for surgery. Average survival was 114.6 day after duodenal stenting and 65% of patients were discharged.

Conclusion:

The right indication and correct placement of SEMS into the duodenum may effectively solve malignant gastric outlet obstruction, leading to improvements in quality of life in end-stage malignant disease.

Key words:

duodenal stent – self-expandable metallic stent – gastric outlet obstruction – supportive care

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

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