The team assessed the use of enteral stents, as an alternative to palliative surgery, for non-esophageal malignant upper GI obstruction. They reported their findings in the March issue of Gastrointestinal Endoscopy.
The researchers reviewed data on all patients who had undergone enteral stent placement at two institutions.
|Costs of treatment and duration of hospitalization:|
Enteral stent placement:
$9,921 and 4 days
$28,173 and 14 days
Individuals with a diagnosis of pancreatic cancer were compared with another similar cohort of patients who underwent palliative gastrojejunostomy.
31 procedures were performed on 29 patients (mean age 67.7 years; 13 men, 16 women).
The diagnoses were gastric (13.8%), duodenal (10.3%), pancreatic (41.4%), metastatic (27.6%), and other malignancies (6.9%).
Malignant obstruction was found to occur at the pylorus (20.7%), first part of duodenum (37.9%), second part of duodenum (27.6%), third part of duodenum (3.5%), and anastomotic sites (10.3%).
93.5% of procedures were successful, and good clinical outcome was achieved in 80.6%. Re-obstruction by tumor ingrowth occurred in 2 patients after a mean of 183 days.
The median survival time for patients with pancreatic cancer who underwent enteral stent placement compared with those who underwent surgical gastrojejunostomy was 94 and 92 days, respectively. Charges were $9,921 and $28,173, and duration of hospitalization was 4 and 14 days, respectively.
Researcher Heng Boon Yim, of the Tan Tock Seng Hospital, Singapore, concluded on behalf of the group, "Endoscopic enteral stent placement of non-esophageal malignant upper GI obstruction is a safe, efficacious, and cost-effective procedure with good clinical outcome, lower charges, and shorter hospitalization period than the surgical alternative."