Gastric outlet obstruction can occur due to biliopancreatic tumors. However, metallic self-expanding stents, inserted under endoscopic and fluoroscopic guidance, can be used for palliation.
In this study, researchers from France evaluated the feasibility, efficacy, and complications of endoscopic duodenal stenting in patients with malignant gastric outlet obstruction.
The team studied 63 patients (mean age 73 years) who presented with clinical symptoms of duodenal obstruction, between 1998 and 2001.
The patients underwent endoscopic stenting with large metallic prostheses.
|Stenting was immediately successful in 95% of patients.|
The researchers assessed any complications, and the clinical outcomes.
The team found that 58 patients required 1 duodenal stent, while 5 required 2 overlapping stents.
They determined that stenting was immediately successful in 95% of patients.
They found that at the time of the duodenal procedure, 25 previously inserted biliary stents were still patent. The team attempted biliary stenting during the same procedure in 18 patients. Of the 63 patients, 20 had no biliary stricture.
There was no procedure-related mortality.
The team found that complications occurred in 30 % of patients. There were 13 stent obstructions, 4 stent migrations, and 2 duodenal perforations.
They determined that 70 % of the patients had no further digestive problem for their remaining lifetime.
Furthermore, an exclusively peroral diet was possible in 92% of patients. This was considered satisfactory in 73 %.
Of the 63 patients, 84 % died between 1 and 64 weeks after the duodenal stenting. The team found that median survival was 7 weeks.
Dr Nassif's team concluded, "Endoscopic stenting for the palliation of malignant gastric outlet obstruction is feasible and well-tolerated in most patients".
"Most dysfunctions can be managed endoscopically".