Article: article from journal or magazin.
Malignant gastroduodenal obstruction: palliation with self-expanding metallic stents.
Journal of Vascular and Interventional Radiology
2 Pt 1
Publication types: Journal Article
PURPOSE: To evaluate the feasibility, efficacy, and tolerance of self-expanding metallic stent insertion under fluoroscopic guidance for palliation of symptoms related to malignant gastroduodenal obstruction. MATERIALS AND METHODS: Seventy-two patients (38 men, 34 women) aged 25-98 years (mean, 62 years) with duodenal (n = 43), antropyloric (n = 13), surgical gastrojejunostomy (n = 10), or pyloroduodenal (n = 6) malignant obstruction were referred for insertion of self-expanding metallic stents over a 6-year period. Stent insertion was performed with use of a peroral or transgastric approach when necessary (n = 11). RESULTS: Stents were successfully inserted in 70 of the 72 patients (97%) and provided symptom relief in 65 patients (90%). Inserted stents were mainly uncovered vascular (n = 55) or enteral (n = 10) Wallstents. One hundred eight stents were initially inserted: one, two, three, or four stents were indicated in 43, 17, nine, and one patient, respectively. Mean follow-up was 119 days (range, 4-513 days). Mean stent patency was 113 days (range, 4-513 days). Mean survival of patients was 120 days. During follow-up, stent obstruction occurred in seven patients as a result of tumoral overgrowth (n = 5) or ingrowth (n = 2). Complications occurred in 12 of the 72 patients (17%), including stent migration (n = 8), stent fracture (n = 1), duodenal perforation (n = 1), and death related to general anesthesia (n = 1). CONCLUSION: Despite a significant complication rate, self-expanding metallic stent insertion under fluoroscopic guidance appears to be a feasible and useful technique in the palliative management of malignant gastroduodenal obstruction.
Abdominal Neoplasms/complications, Adult, Aged, Aged, 80 and over, Duodenal Obstruction/etiology, Duodenal Obstruction/therapy, Equipment Design, Feasibility Studies, Female, Fluoroscopy, Follow-Up Studies, Foreign-Body Migration/etiology, Gastric Outlet Obstruction/etiology, Gastric Outlet Obstruction/therapy, Humans, Jejunum/surgery, Male, Middle Aged, Palliative Care, Radiography, Interventional, Recurrence, Retrospective Studies, Stents/adverse effects, Stomach/surgery, Survival Rate, Treatment Outcome
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