Treatment of malignant gastroduodenal obstruction with a nitinol self-expanding metal stent: an international prospective multicentre registry

Dig Liver Dis. 2012 Jan;44(1):37-43. doi: 10.1016/j.dld.2011.08.012. Epub 2011 Sep 19.

Abstract

Background: Duodenal stenting has become a broadly accepted first line of treatment for patients with advanced malignant gastroduodenal obstruction as these patients are difficult to treat and are poor surgical candidates.

Aims: To document duodenal stent performance for palliative management of malignant gastroduodenal obstruction.

Methods: Multicentre, single arm, prospective registry documenting peroral endoscopic duodenal stenting procedures in 202 patients.

Results: Technical success achieved in 98% (CI, 95%, 99%) of stent placements. Increase of Gastric Outlet Obstruction Score by at least 1 point compared to baseline was achieved in 91% (CI, 86%, 95%) of patients persisting for a median of 184 days (CI, 109, 266). By day 5 (CI, 4, 6) after stent placement, 50% of patients experienced a score increase of at least 1 point. Improvement from 14% of patients at baseline tolerating soft solids or low residue/normal diet to 84% at 15 days, 86% at 30 days, 81% at 90 days, 79% at 180 days, and 70% at 270 days. Complications included stent ingrowth and/or overgrowth (12.4%), transient periprocedural symptoms (3%), bleeding (3%), stent migration (1.5%), and perforation (0.5%).

Conclusions: Safety and effectiveness of duodenal stenting for palliation of malignant gastroduodenal obstruction was confirmed in the largest international prospective series to date.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alloys
  • Duodenal Obstruction / etiology
  • Duodenal Obstruction / therapy*
  • Endoscopy, Gastrointestinal
  • Female
  • Follow-Up Studies
  • Gastric Outlet Obstruction / etiology
  • Gastric Outlet Obstruction / therapy*
  • Gastrointestinal Neoplasms / complications*
  • Humans
  • Male
  • Prospective Studies
  • Prosthesis Design
  • Registries
  • Stents / adverse effects*
  • Survival Analysis

Substances

  • Alloys
  • nitinol