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Palliative stenting for late malignant gastric outlet obstruction. J Gastrointest Surg 2007 Jan;11(1):107-13

Date

03/29/2007

Pubmed ID

17390196

DOI

10.1007/s11605-006-0060-4

Scopus ID

2-s2.0-34250204156 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

Malignant gastric outlet obstruction (MGO) is a late complication of pancreatobiliary and gastric cancers. Although surgical gastrojejunostomy provides good palliation, many of these patients may be nonoperative candidates or underwent previous extensive resection such as a Whipple procedure. Recently, endoscopically placed self-expanding metallic stents (SEMS) have been used to palliate MGO. The aim of this study was to evaluate the efficacy of SEMS for palliation of late MGO. Medical records of patients with endoscopic placement of SEMS for palliation of MGO were reviewed. Results showed that 30 patients with MGO had SEMS placed for late gastroduodenal (n = 20) or jejunal (n = 10) obstruction. Twenty-one patients (70%) had previous surgery. Return to oral feeding was observed in 90% of patients who presented with recurrent obstruction after prior bypass surgery and in 88% of nonoperative patients in whom SEMS were placed as the primary therapy for obstruction. No major complications were observed, and median survival after SEMS was 4.1 months (0.1 to 10.5 months). SEMS also did not interfere with biliary drainage. In conclusion, endoscopically placed SEMS are safe and provide good palliation for late malignant gastroduodenal and jejunal strictures and are an excellent complement to recurrent obstruction after surgical gastrojejunostomy.

Author List

Kiely JM, Dua KS, Graewin SJ, Nakeeb A, Erickson BA, Ritch PS, Wilson SD, Pitt HA

Author

Kulwinder S. Dua MD Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Female
Gastric Outlet Obstruction
Gastrointestinal Neoplasms
Humans
Male
Middle Aged
Palliative Care
Recurrence
Retrospective Studies
Statistics, Nonparametric
Stents
Survival Rate
Treatment Outcome