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A Newly Designed Stent for Management of Malignant Distal Duodenal Stenosis

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Abstract

Purpose

To evaluate the clinical effectiveness of a newly designed stent for the treatment of malignant distal duodenal stenosis.

Methods

From March 2011 to May 2013, six patients with malignant duodenal stenosis underwent fluoroscopically guided placement of the new duodenal stent consisting of braided, nested stent wires, and a delivery system with a metallic mesh inner layer. Primary diseases were pancreatic cancer in three patients, gastric cancer in two patients, and endometrial stromal sarcoma in one patient. Duodenal obstructions were located in the horizontal part in two patients, the ascending part in two patients, and the duodenojejunal flexure in two patients. Technical success, defined as the successful stent deployment, clinical symptoms before and after the procedure, and complications were evaluated.

Results

Technical success was achieved in all patients. No major complications were observed. Before treatment, two patients could not take any food and the gastric outlet obstruction scoring system (GOOSS) score was 0; the other four patients could take only liquids orally (GOOSS score = 1). After treatment, five patients could take soft food (GOOSS score = 2) and one patient could take a full diet (GOOSS score = 3). The mean duration of primary stent patency was 115.7 days.

Conclusions

The newly designed stent is associated with a high degree of technical success and good clinical outcome and may be clinically effective in the management of malignant distal duodenal obstruction.

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References

  1. Weaver DW, Wiencek RG, Bouwman DL, Walt AJ (1987) Gastrojejunostomy: is it helpful for patients with pancreatic cancer? Surgery 102(4):608–613

    CAS  PubMed  Google Scholar 

  2. van Wagensveld BA, Coene PP, van Gulik TM et al (1997) Outcome of palliative biliary and gastric bypass surgery for pancreatic head carcinoma in 126 patients. Br J Surg 84(10):1402–1406. PMID: 9361599

    Article  PubMed  Google Scholar 

  3. Lillemoe KD, Cameron JL, Hardacre JM et al (1999) Is prophylactic gastrojejunostomy indicated for unresectable periampullary cancer? A prospective randomized trial. Ann Surg 230(3):322–328

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Isla AM, Worthington T, Kakkar AK, Williamson RC (2000) A continuing role for surgical bypass in the palliative treatment of pancreatic carcinoma. Dig Surg 17(2):143–146

    Article  CAS  PubMed  Google Scholar 

  5. Choi YB (2002) Laparoscopic gastrojejunostomy for palliation of gastric outlet obstruction in unresectable gastric cancer. Surg Endosc 16(11):1620–1626

    Article  PubMed  Google Scholar 

  6. Johnsson E, Thune A, Liedman B (2004) Palliation of malignant gastroduodenal obstruction with open surgical bypass or endoscopic stenting: clinical outcome and health economic evaluation. World J Surg 28(8):812–817

    Article  PubMed  Google Scholar 

  7. Mittal A, Windsor J, Woodfield J, Casey P, Lane M (2004) Matched study of three methods for palliation of malignant pyloroduodenal obstruction. Br J Surg 91(2):205–209

    Article  CAS  PubMed  Google Scholar 

  8. Maetani I, Akatsuka S, Ikeda M et al (2005) Self-expandable metallic stent placement for palliation in gastric outlet obstructions caused by gastric cancer: a comparison with surgical gastrojejunostomy. J Gastroenterol 40(10):932–937

    Article  CAS  PubMed  Google Scholar 

  9. Fiori E, Lamazza A, Volpino P et al (2004) Palliative management of malignant antro-pyloric strictures. Gastroenterostomy vs. endoscopic stenting. A randomized prospective trial. Anticancer Res 24(1):269–271

    PubMed  Google Scholar 

  10. Pinto IT (1997) Malignant gastric and duodenal stenosis: palliation by peroral implantation of a self-expanding metallic stent. Cardiovasc Interv Radiol 20(6):431–434

    Article  CAS  Google Scholar 

  11. Gutzeit A, Binkert CA, Schoch E, Sautter T, Jost R, Zollikofer CL (2009) Malignant gastroduodenal obstruction: treatment with self-expanding uncovered wallstent. Cardiovasc Interv Radiol 32(1):97–105

    Article  Google Scholar 

  12. Kim JH, Song HY, Shin JH et al (2007) Metallic stent placement in the palliative treatment of malignant gastroduodenal obstructions: prospective evaluation of results and factors influencing outcome in 213 patients. Gastrointest Endosc 66(2):256–264

    Article  PubMed  Google Scholar 

  13. Brimhall B, Adler DG (2011) Enteral stents for malignant gastric outlet obstruction. Gastrointest Endosc Clin N Am 21(3):389–403

    Article  PubMed  Google Scholar 

  14. Woo SM, Kim DH, Lee WJ et al (2013) Comparison of uncovered and covered stents for the treatment of malignant duodenal obstruction caused by pancreaticobiliary cancer. Surg Endosc 27(6):2031–2039

    Article  PubMed  Google Scholar 

  15. Jeurnink SM, Repici A, Luigiano C, Pagano N, Kuipers EJ, Siersema PD (2009) Use of a colonoscope for distal duodenal stent placement in patients with malignant obstruction. Surg Endosc 23(3):562–567

    Article  PubMed  Google Scholar 

  16. Adler DG, Baron TH (2002) Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients. Am J Gastroenterol 97(1):72–78

    Article  PubMed  Google Scholar 

  17. Karnofsky DA, Burchenal JH (1949) The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM (ed) Evaluation of chemotherapeutic agents. Columbia University Press, New York, p 196

    Google Scholar 

  18. Baron TH, Harewood GC (2003) Enteral self-expandable stents. Gastrointest Endosc 58(3):421–433

    Article  PubMed  Google Scholar 

  19. Kim CG, Choi IJ, Lee JY et al (2010) Covered versus uncovered self-expandable metallic stents for palliation of malignant pyloric obstruction in gastric cancer patients: a randomized, prospective study. Gastrointest Endosc 72(1):25–32

    Article  PubMed  Google Scholar 

  20. Telford JJ, Carr-Locke DL, Baron TH et al (2004) Palliation of patients with malignant gastric outlet obstruction with the enteral wallstent: outcomes from a multicenter study. Gastrointest Endosc 60(6):916–920

    Article  PubMed  Google Scholar 

  21. Sasaki T, Isayama H, Maetani I et al (2013) Japanese multicenter estimation of WallFlex duodenal stent for unresectable malignant gastric outlet obstruction. Dig Endosc 25(1):1–6

    Article  PubMed  Google Scholar 

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Conflict of interest

Wei-Zhong Zhou, Zheng-Qiang Yang, Sheng Liu, Chun-Gao Zhou, Jin-Guo Xia, Lin-Bo Zhao, and Hai-Bin Shi declared no conflict of interest.

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Correspondence to Zheng-Qiang Yang.

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Zhou, WZ., Yang, ZQ., Liu, S. et al. A Newly Designed Stent for Management of Malignant Distal Duodenal Stenosis. Cardiovasc Intervent Radiol 38, 177–181 (2015). https://doi.org/10.1007/s00270-014-0899-9

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  • DOI: https://doi.org/10.1007/s00270-014-0899-9

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