Experience of Double Stenting in Malignant Biliary and Duodenal Obstruction in Patients With Adenocarcinoma of the Pancreatic Head

Abstract

Biliary (BO) and duodenal obstruction (DO) are a common complication in patients with pancreatic head adenocarcinoma. In the surgical clinic of the Botkin Hospital (Moscow) for the period from 2013 to 2017 21 patients with BO and DO due to adenocarcinoma of the pancreatic head were treated with double stenting with nitinol self-expandable stents (8 males, 13 females; mean age 68 ± 2.3 years). The level of obstruction of the gastrointestinal tract according to Mutignani: Type I - 6, Type II - 12, Type III - 3. A total of 43 stents were implanted into 21 patients (2 patients had 2 biliary stents implanted). The technical success of biliary stenting was 100%. The average serum bilirubin level before biliary stenting was 314.2 ± 96.3 mmol / l and decreased to 32.6 ± 11.8 mmol / l 7 days after stenting (p>0.05). The efficiency of the biliary stent was 46 ± 4.5 weeks. The technical success of duodenal stenting was 91.3%. Clinical success was achieved in 20 (95.2%) patients (GOOSS score prior to stenting, 0.4 ± 0.13; GOOSS score after stenting, 2.3 ± 0.5). The efficiency of the duodenal stent was 34 ± 6.1 weeks. The survival time in 17 patients was 5-21 months (median - 10.1 ± 3.8 months).