Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients

Am J Gastroenterol. 2002 Jan;97(1):72-8. doi: 10.1111/j.1572-0241.2002.05423.x.


Objective: Malignant gastric outlet obstruction is seen in the setting of a variety of cancers, most commonly pancreatic. Self-expanding metal stents can be used to palliate these patients and restore the ability to eat.

Methods: We reviewed the Mayo Clinic experience in the endoscopic treatment of malignant gastric outlet obstruction. Thirty-six patients (26 male, 10 female) were treated between October, 1998 and January, 2001. Data were collected from charts, endoscopy reports, x-rays, and telephone calls. A scoring system was created to grade the ability to eat.

Results: All procedures were successful. Thirty-one of 36 patients (86%) required one stent at initial endoscopy, and 5/36 patients (14%) required two or more stents. Pretreatment, 19/36 patients (53%) were nil per os, 15/36 (42%) drank liquids, and 2/36 were able to eat soft solids. After stent placement, only 1/36 (3%) was still nil per os, 13/36 (36%) drank liquids, 13/36 (36%) ate soft solids, and 9/36 (25%) ate a full diet. The improvement in ability to eat using the scoring system was statistically significant (p < 0.0001). Nine of 36 patients (25%) required reintervention for recurrent symptoms. Sixteen of 36 patients (44%) had concomitant or subsequent development of biliary obstruction, of which 15 were successfully decompressed.

Conclusions: Self-expanding metal stents are a safe and efficacious method for palliating malignant gastric outlet obstruction. The majority of patients do not require reintervention, and those that do can usually be managed nonoperatively.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Duodenal Neoplasms / diagnostic imaging
  • Duodenal Neoplasms / pathology
  • Female
  • Follow-Up Studies
  • Gastric Outlet Obstruction / diagnostic imaging
  • Gastric Outlet Obstruction / etiology
  • Gastric Outlet Obstruction / therapy*
  • Gastroscopy / methods*
  • Humans
  • Male
  • Middle Aged
  • Palliative Care / methods*
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / diagnostic imaging
  • Probability
  • Quality of Life
  • Radiography
  • Retrospective Studies
  • Statistics, Nonparametric
  • Stents*
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / diagnostic imaging
  • Treatment Outcome