Uncovered self-expandable metallic stent placement as a first-line palliative therapy in unresectable malignant duodenal obstruction.

Abstract

OBJECTIVE:

To report treatment outcomes and complications of uncovered self-expandable metallic stents (SEMS) as a first-line therapy for inoperable malignant duodenal obstructions in our hospital.

METHODS:

A retrospective analysis was performed in patients who had undergone placement of uncovered SEMS as a first-line therapy for inoperable malignant duodenal obstruction from August 2001 to July 2011. Treatment outcomes and complications of the procedures were investigated.

RESULTS:

In total, 47 patients (25 men; mean age 65 years) underwent the procedure. The technical and clinical success rates were 93.6% and 83.0%, respectively. Early complications occurred in 8 patients, including two guidewire-induced micro-perforations and six pancreatitis. All these 8 patients recovered with conservative treatment. Six late complications requiring additional procedures consisted of five stent occlusions due to tumor ingrowth and one stent migration. Four stent occlusions and one migration were treated by the placement of an additional covered stent and the remaining case was treated by balloon dilatation. The median primary stent patency period and median survival period after primary stent placement were 103 days and 131 days, respectively.

CONCLUSIONS:

Uncovered SEMS placement is effective as a first-line palliative therapy for inoperable malignant duodenal obstruction. Complications such as stent occlusion or migration can be easily managed with additional covered SEMS.

• Authors: Hyung Su Ahn, Su Jin Hong, Jong Ho Moon, Bong Min Ko, Hyun Jong Choi, Jae Pil Han, Jin Seok Park, Myung Soo Kang, Joo Young Cho, Joon Seong Lee, Moon Sung Lee
• Journal: Journal of digestive diseases (J Dig Dis) Vol. 13 Issue 12 Pg. 628-33 (Dec 2012) ISSN: 1751-2980 [Electronic] Australia
• PMID: 23134154 (Publication Type: Journal Article)
• Copyright: © 2012 The Authors. Journal of Digestive Diseases © 2012 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Chemical References

• Metals

Topics

• Adult
• Aged
• Aged, 80 and over
• Duodenal Neoplasms (mortality)
• Female
• Follow-Up Studies
• Humans
• Intestinal Obstruction (mortality, therapy)
• Kaplan-Meier Estimate
• Male
• Metals
• Middle Aged
• Palliative Care (methods, statistics & numerical data)
• Retrospective Studies
• Stents (adverse effects, statistics & numerical data)