Abstract
Expandable stents have now become accepted for the relief of malignant obstruction throughout the gastrointestinal tract and biliary system. Enteric stents, as defined in this chapter, are stents placed in the stomach and small bowel (including retrograde approach to distal small bowel disease) for management of a variety of benign and malignant disease processes. The vast majority of enteric stents are placed for relief of malignant obstruction, although such stents are also placed for the management of benign disease including obstruction and/or fistula. The clinical response to these devices is dependent on proper stent placement and the anatomical location in which they are placed. Proper stent placement, in turn, is dependent on being familiar with the characteristics of the devices, having knowledge of the length of the stricture, precise localization of a fistula, if present, and location of the disease process within the gastrointestinal tract. This chapter summarizes the techniques for optimal placement of expandable stents in the stomach and small bowel.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Baron TH. Expandable gastrointestinal stents. Gastroenterol. 2007;133:1407–11.
Baron TH. Minimizing endoscopic complications: endoluminal stents. Gastrointest Endosc Clin N Am. 2007;17:83–104.
Eisendrath P, Cremer M, Himpens J, et al. Endotherapy including temporary stenting of fistulas of the upper gastrointestinal tract after laparoscopic bariatric surgery. Endoscopy. 2007;39:625–30.
Kriwanek S, Ott N, Ali-Abdullah S, et al. Treatment of gastro-jejunal leakage and fistulization after gastric bypass with coated self-expanding stents. Obes Surg. 2006;16:1669–74.
Merrifield BF, Lautz D, Thompson CC. Endoscopic repair of gastric leaks after Roux-en-Y gastric bypass: a less invasive approach. Gastrointest Endosc. 2006;63:710–4.
Nguyen NT, Nguyen XM, Dholakia C. The use of endoscopic stent in management of leaks after sleeve gastrectomy. Obes Surg. 2010;20:1289–92.
Trelles N, Gagner M, Palermo M, et al. Gastrocolic fistula after re-sleeve gastrectomy: outcomes after esophageal stent implantation. Surg Obes Relat Dis. 2010;6:308–12.
Eubanks S, Edwards CA, Fearing NM, et al. Use of endoscopic stents to treat anastomotic complications after bariatric surgery. J Am Coll Surg. 2008;206:935–8. discussion 938–39.
Serra C, Baltasar A, Andreo L, et al. Treatment of gastric leaks with coated self-expanding stents after sleeve gastrectomy. Obes Surg. 2007;17:866–72.
Edwards CA, Bui TP, Astudillo JA. Management of anastomotic leaks after Roux-en-Y bypass using self-expanding polyester stents. Surg Obes Relat Dis. 2008;4:594–9. discussion 599–600.
Swinnen J, Eisendrath P, Rigaux J, et al. Self-expandable metal stents for the treatment of benign upper GI leaks and perforations. Gastrointest Endosc. 2011;73:890–9.
Wu G, Li YD, Han XW, Ding PX. An integrated, self-expanding, Y-shaped, metallic stent for patients with complex obstruction after gastrojejunostomy (Billroth II): initial experience. Radiol Med. 2011;116:759–65.
Levine RA, Wasvary H, Kadro O. Endoprosthetic management of refractory ileocolonic anastomotic strictures after resection for Crohn’s disease: report of nine-year follow-up and review of the literature. Inflamm Bowel Dis. 2012;18:506–12.
Rejchrt S, Kopacova M, Brozik J, Bures J. Biodegradable stents for the treatment of benign stenoses of the small and large intestines. Endoscopy. 2011;43:911–7.
Adler DG, Baron TH. Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients. Am J Gastroenterol. 2002;97:72–8.
Jeurnink SM, van Eijck CH, Steyerberg EW, et al. Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review. BMC Gastroenterol. 2007;7:18.
Jeurnink SM, Steyerberg EW, van Hooft JE, et al. Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT study): a multicenter randomized trial. Gastrointest Endosc. 2010;71:490–9.
Jeurnink SM, Steyerberg EW, Vleggaar FP, et al. Predictors of survival in patients with malignant gastric outlet obstruction: a patient-oriented decision approach for palliative treatment. Dig Liver Dis. 2011;43:548–52.
Small AJ, Petersen BT, Baron TH. Closure of a duodenal stent-induced perforation by endoscopic stent removal and covered self-expandable metal stent placement (with video). Gastrointest Endosc. 2007;66:1063–5.
González-Moreno S, González-Bayón L, Ortega-Pérez G, González-Hernando C. Imaging of peritoneal carcinomatosis. Cancer J. 2009;15(3):184–9.
Mendelsohn RB, Gerdes H, Markowitz AJ, et al. Carcinomatosis is not a contraindication to enteral stenting in selected patients with malignant gastric outlet obstruction. Gastrointest Endosc. 2011;73:1135–40.
Kim CG, Choi IJ, Lee JY, et al. Covered versus uncovered self-expandable metallic stents for palliation of malignant pyloric obstruction in gastric cancer patients: a randomized, prospective study. Gastrointest Endosc. 2010;72(1):25–32.
Tierney W, Chuttani R, Croffie J, et al. Enteral stents. Gastrointest Endosc. 2006;63:920–6.
Sharma VK, Xie QY, Hassan HA, Howden CW. Placement of a covered metal stent via gastrostomy for management of malignant duodenocolic fistula with duodenal obstruction. Gastrointest Endosc. 2002;55(7):937–40.
Maetani I, Tada T, Shimura J. Technical modifications and strategies for stenting gastric outlet strictures using esophageal endoprostheses. Endoscopy. 2002;34:402–6.
Ikeda T, Ueda N, Yonemura Y. Peroral placement of a self-expandable covered metallic stent using an overtube for malignant gastroduodenal obstructions. Surg Today. 2011;41:637–42.
Baron TH. Management of simultaneous biliary and duodenal obstruction: the endoscopic perspective. Gut Liver. 2010;4(Suppl 1):S50–6.
GarcÃa-Cano J. Use of an ultrathin gastroscope to allow endoscopic insertion of enteral Wallstents without fluoroscopic monitoring. Dig Dis Sci. 2006;51:1231–5.
Ross AS, Semrad C, Waxman I, Dye C. Enteral stent placement by double balloon enteroscopy for palliation of malignant small bowel obstruction. Gastrointest Endosc. 2006;64:835–7.
Lennon AM, Chandrasekhara V, Shin EJ, Okolo 3rd PI. Spiral-enteroscopy-assisted enteral stent placement for palliation of malignant small-bowel obstruction (with video). Gastrointest Endosc. 2010;71:422–5.
Saleem A, Bakken J, Baron TH. Early massive bleeding after duodenal self-expandable metal stent placement for palliation of malignant gastric outlet obstruction (with video). Gastrointest Endosc. 2011;74:1426–7.
Cope C, Clark TW, Ginsberg G, Habecker P. Stent placement of gastroenteric anastomoses formed by magnetic compression. J Vasc Interv Radiol. 1999;10:1379–86.
Cope C, Ginsberg GG. Long-term patency of experimental magnetic compression gastroenteric anastomoses achieved with covered stents. Gastrointest Endosc. 2001;53:780–4.
van Hooft JE, Vleggaar FP, Le Moine O, et al. Endoscopic magnetic gastroenteric anastomosis for palliation of malignant gastric outlet obstruction: a prospective multicenter study. Gastrointest Endosc. 2010;72:530–5.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Baron, T. (2013). Enteric Stents: Indications and Placement Techniques. In: Kozarek, R., Baron, T., Song, HY. (eds) Self-Expandable Stents in the Gastrointestinal Tract. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3746-8_11
Download citation
DOI: https://doi.org/10.1007/978-1-4614-3746-8_11
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-3745-1
Online ISBN: 978-1-4614-3746-8
eBook Packages: MedicineMedicine (R0)