Duodenal stenting for malignant gastric outlet obstruction: Prospective study

Moura, Eduardo Guimarães Hourneaux de; Ferreira, Francirosy Campos Barbosa; Cheng, Spencer; Sakai, Paulo; Zilberstain, Bruno

doi:10.3748/wjg.v18.i9.938

Cited by 31 publications

(19 citation statements)

References 26 publications

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“…This is the fourth report on the use of an enteral WallFlex stent only. In previous studies, complications relevant to enteral WallFlex stent placement, namely hemorrhage (0–4%), perforation (0–5%), cholangitis (2–6%), and sepsis (0–2%) have been reported (Table ) . Post‐procedural pancreatitis has never been reported with the use of a WallFlex stent.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of a WallFlex enteral stent for malignant gastric obstruction

Kanno

Ito

Fujita

et al. 2012

Digestive Endoscopy

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of a WallFlex enteral stent for malignant gastric obstruction

Kanno

Ito

Fujita

et al. 2012

Digestive Endoscopy

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“…Studies reported perforation, bleeding, abdominal pain, obstruction and migration of the SEMS 13 32 33 34 35. High heterogeneity was observed in the overall complications analysis.…”

Section: Discussionmentioning

confidence: 99%

Stents and surgical interventions in the palliation of gastric outlet obstruction: a systematic review

et al. 2016

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Background and study aims: Palliative treatment of gastric outlet obstruction can be done with surgical or endoscopic techniques. This systematic review aims to compare surgery and covered and uncovered stent treatments for gastric outlet obstruction (GOO). Patients and methods: Randomized clinical trials were identified in MEDLINE, Embase, Cochrane, LILACs, BVS, SCOPUS and CINAHL databases. Comparison of covered and uncovered stents included: technical success, clinical success, complications, obstruction, migration, bleeding, perforation, stent fracture and reintervention. The outcomes used to compare surgery and stents were technical success, complications, and reintervention. Patency rate could not be included because of lack of uniformity of the extracted data. Results: Eight studies were selected, 3 comparing surgery and stents and 5 comparing covered and uncovered stents.The meta-analysis of surgical and endoscopic stent treatment showed no difference in the technical success and overall number of complications. Stents had higher reintervention rates than surgery (RD: 0.26, 95 % CI [0.05, 0.47], NNH: 4). There is no significant difference in technical success, clinical success, complications, stent fractures, perforation, bleeding and the need for reintervention in the analyses of covered and uncovered stents. There is a higher migration rate in the covered stent therapy compared to uncovered self-expanding metallic stents (SEMS) in the palliation of malignant GOO (RD: 0.09, 95 % CI [0.04, 0.14], NNH: 11). Nevertheless, covered stents had lower obstruction rates (RD: – 0.21, 95 % CI [-0.27, – 0.15], NNT: 5). Conclusions: In the palliation of malignant GOO, covered SEMS had higher migration and lower obstruction rates when compared with uncovered stents. Surgery is associated with lower reintervention rates than stents.

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“…Rövidítések ERCP = endoszkópos retrográd cholangiopancreatographia; Fr = French, mértékegység, 1 French = 0,33 mm; GOOSSscore = (Gastric Outlet Obstruction Scoring System) a gyomorkimenet-elzáródás mértékét meghatározó skála; in = inch, mértékegység, 1 inch = 2,54 cm; PTD = percutan transhepaticus drenázs A malignus gastroduodenalis obstrukció hátterében leggyakrabban a pancreatobiliaris rendszer -elsősorban a pancreasfej -daganatos elváltozásai, illetve peripyloricus gyomortumorok, valamint a duodenum elsődleges vagy másodlagos daganatos elváltozásai állnak [1,2,3]. A klasszikus sebészeti palliáció -gastroenteroanastomosis -mellett vagy helyett hazánkban is egyre több endoszkópos centrumban válik gyakorlattá az enteralis stenttel történő endoszkópos palliáció [3,4,5].…”

Section: Eredeti Közleményunclassified

“…A klasszikus sebészeti palliáció -gastroenteroanastomosis -mellett vagy helyett hazánkban is egyre több endoszkópos centrumban válik gyakorlattá az enteralis stenttel történő endoszkópos palliáció [3,4,5]. [1,6,7]: -öntágulós fedetlen fémstent, -fedett fémstent [8], -részlegesen fedett, úgynevezett "big cup" Hanaro DPC-stent [9], -60-80-100-120-140 mm hossz-és 18-20-22-24 mm átmérőméretek.…”

Section: Eredeti Közleményunclassified

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Malignus gastroduodenalis obstrukció endoszkópos palliációja fedetlen enteralis stenttel

et al. 2015

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Bevezetés: A malignus gastroduodenalis obstrukció palliatív kezelése enteralis stentekkel hatékony és biztonságos módszer, a palliatív céllal elkészített gastroenterostomia reális alternatívája. Célkitűzés: A szerzők ismertetik a malignus gastroduodenalis obstrukció hátterében fennálló leggyakoribb daganatos betegségeket, a stent kiválasztásának szempontjait, behelyezési technikáját, valamint elemzik a kezelés technikai és klinikai sikerességét, megemlítve a lehetséges komplikációkat. Módszer: 2013. március 1. és 2015. április 9. között 19 esetben történt fedetlen, öntágulós enteralis stentbehelyezés. A 19 beteg közül 6 nő, 13 férfi , átlagéletkoruk 67 év volt. A stentelés indikációját 5 esetben peripyloricus gyomortumor, 1-1 esetben a duodenum, gastroenteralis anastomosis, Vater-papilla és az epehólyag malignus folyamata, 7 esetben pancreas, 3 esetben az epeút tumora képezte. Eredmények: A stentbehelyezés technikai sikeressége 100%-os volt. A klinikai siker objektivizálása a Gastric Outlet Obstruction Scoring System alapján történt. Következtetések: Az enteralis stentek alkalmazása malignus gastroduodenalis obstrukcióban technikailag jól kivitelezhető, biztonságos módszer, amely látványosan csökkenti a betegség tüneteit, javítja az életminőséget. Orv. Hetil., 2015, 156(44), 1778-1781.Kulcsszavak: enteralis stent, malignus gastroduodenalis obstrukció, stentbehelyezés, duodenumszűkület Palliative endoscopic treatment of malignant gastroduodenal obstructions with uncovered enteral stentsIntroduction: Palliative treatment of malignant gastroduodenal obstructions with enteral stents is an effective and safe method, and a viable alternative to gastroenterostomy. Aim: The authors present the most common malignancies behind gastroduodenal obstructions, the aspects of stent selections, insertion techniques, technical and clinical success rates, and possible procedure-related complications. Method: Between 1 March, 2013 and 9 April, 2015 nineteen patients were treated with uncovered, self-expandable enteral stents. Out of the 19 patients, 6 were females and 13 males, with an average age of 67 years. Indications of stenting were peripyloric ventricular tumour in fi ve cases, malignancies of the duodenum, gastroenteralis anastomosis, Vater papilla and gallbladder in one case respectively, pancreatic tumor in seven cases and bile duct malignancies in three cases. Results: The technical success rate of stent placement was 100%. The evaluation of clinical success was analised on the basis of the Gastric Outlet Obstruction Scoring System. Conclusions: The use of enteral stents in malignant gastroduodenal obstructions is a reliable and safe method, which promptly decreases symptoms of the patients and improves their quality of life.

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Duodenal stenting for malignant gastric outlet obstruction: Prospective study

Abstract: Enteral stenting to alleviate gastroduodenal malignant obstruction improves quality of life in patients with limited life expectancy, which can be evaluated by using a GOO scoring system.

Cited by 31 publications

References 26 publications

Efficacy and safety of a WallFlex enteral stent for malignant gastric obstruction

Efficacy and safety of a WallFlex enteral stent for malignant gastric obstruction

Stents and surgical interventions in the palliation of gastric outlet obstruction: a systematic review

Malignus gastroduodenalis obstrukció endoszkópos palliációja fedetlen enteralis stenttel

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