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Malignant Gastroduodenal Obstruction: Treatment with Self-Expanding Uncovered Wallstent

  • Andreas GutzeitEmail author
  • Christoph A. Binkert
  • Eric Schoch
  • Thomas Sautter
  • Res Jost
  • Christoph L. Zollikofer
Clinical Investigation

Abstract

Purpose: To retrospectively evaluate the clinical effectiveness of a self-expanding uncovered Wallstent in patients with malignant gastroduodenal obstruction. Materials and Methods: Under combined endoscopic and fluoroscopic guidance, 29 patients with a malignant gastroduodenal stenosis were treated with a self-expanding uncovered metallic Wallstent. A dysphagia score was assessed before and after the intervention to measure the success of this palliative therapy. The dysphagia score ranged between grade 0 to grade 4: grade 0 = able to tolerate solid food, grade 1 = able to tolerate soft food, grade 2 = able to tolerate thick liquids, grade 3 = able to tolerate water or clear fluids, and grade 4 = unable to tolerate anything perorally. Stent patency and patients survival rates were calculated. Results: The insertion of the gastroduodenal stent was technically successful in 28 patients (96.5%). After stenting, 25 patients (86.2%) showed clinical improvement by at least one score point. During follow-up, 22 (78.5%) of 28 patients showed no stent occlusion until death and did not have to undergo any further intervention. In six patients (20.6%), all of whom were treated with secondary stent insertions, occlusion with tumor ingrowth and/or overgrowth was observed after the intervention. The median period of primary stent patency in our study was 240 days. Conclusion: Placement of an uncovered Wallstent is clinically effective in patients with malignant gastroduodenal obstruction. Stent placement is associated with high technical success, good palliation effect, and high durability of stent function.

Keywords

Malignant gastroduodenal stenosis Wallstent Dysphagia Dysphagia score Stent 

Notes

Acknowledgments

We thank Dr. Nicole Graf from the Clinical Trials Center, Center for Clinical Research, University of Zurich, who performed the statistical analysis. We also thank Wolfgang Herzig, who designed and drew the illustrations.

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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Andreas Gutzeit
    • 1
    Email author
  • Christoph A. Binkert
    • 1
  • Eric Schoch
    • 1
  • Thomas Sautter
    • 1
  • Res Jost
    • 2
  • Christoph L. Zollikofer
    • 1
  1. 1.Department of RadiologyKantonsspital WinterthurWinterthurSwitzerland
  2. 2.Department of Internal Medicine, Section of GastroenterologyKantonsspital WinterthurWinterthurSwitzerland

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