Gastrojejunostomy versus duodenal stent placement for gastric outlet obstruction in patients with unresectable pancreatic cancer

Yoshida, Yukio; Fukutomi, Akira; Tanaka, Masaki; Sugiura, Teiichi; Kawata, Noboru; Kawai, Shinya; Kito, Yosuke; Hamauchi, Satoshi; Tsushima, Takahiro; Yokota, Tomoya; Todaka, Akiko; Machida, Nozomu; Yamazaki, Kentaro; Onozawa, Yusuke; Yasui, Hirofumi

doi:10.1016/j.pan.2017.09.011

Cited by 38 publications

(47 citation statements)

References 21 publications

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“…Duodenal or gastric outlet obstruction is common in patients with advanced pancreatic cancer and the most established therapeutic options for this problem are operative gastroenterostomy and the implantation of an endoluminal gastroduodenal SEMS (GDS) ( Figure 1C). Retrospective comparative studies quite homogeneously showed a shorter in hospitalization without significant differences in complications, reinterventions and survival between the groups (42,56,57), with higher score of patency for the surgical patients in the early follow up, but similar rates in the later follow up and earlier oral food intake and shorter time to chemotherapy in the GDS groups (42,57). The complications and risks of GDS include stent migration and blockage from food, debris or tumor ingrowth, as well as bleeding, perforation and blocking the ampulla, possibly causing pancreatitis or cholangitis.…”

Section: Gastroduodenal Obstructionmentioning

confidence: 98%

Palliative therapy in pancreatic cancer—interventional treatment with stents

Waldthaler¹,

Rutkowski²,

Valente³

et al. 2019

Transl. Gastroenterol. Hepatol

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Interventional treatment with stents in pancreatic cancer is a topic that developed during recent years and new fields of palliative stent therapy have evolved. The increasing life expectancy of patients with unresectable pancreatic cancer increases the need for clinical and cost effective therapeutic interventions. Current literature, guidelines, practice and evidence were reviewed. Besides the most obvious biliary stenting via endoscopic retrograde cholangiopancreatography (ERCP), pancreatic and gastroduodenal stenting as well as percutaneous transhepatic cholangiography (PTC) and the rapidly growing field of endosonographic stent implantation in the palliative care of patients with pancreatic cancer are being discussed from several points of view in this review.

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Section: Gastroduodenal Obstructionmentioning

confidence: 98%

Palliative therapy in pancreatic cancer—interventional treatment with stents

Waldthaler¹,

Rutkowski²,

Valente³

et al. 2019

Transl. Gastroenterol. Hepatol

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“…The literature on palliative GJ show good functional outcomes and symptoms relief in up to 70% of patients and reduced re-intervention rates, but it is associated with postoperative complications, such as delayed gastric emptying (DGE)[ 8 , 12 , 14 , 34 , 35 ]. For its part, palliative endoscopic treatment is a well-established procedure today and is considered a valid alternative for avoiding surgery.…”

Section: Palliative Treatment Of Goomentioning

confidence: 99%

“…For its part, palliative endoscopic treatment is a well-established procedure today and is considered a valid alternative for avoiding surgery. The endoscopic approach is associated with shorter length of stay (LOS), faster initial relief and shorter time to oral intake, but also with greater symptom recurrences and risk of stent migration[ 8 , 12 - 14 , 36 - 39 ].…”

Section: Palliative Treatment Of Goomentioning

confidence: 99%

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Laparoscopic gastrojejunostomy for gastric outlet obstruction in patients with unresectable hepatopancreatobiliary cancers: A personal series and systematic review of the literature

Manuel-Vázquez

Latorre-Fragua

Ramiro-Pérez

et al. 2018

WJG

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The major symptoms of advanced hepatopancreatic-biliary cancer are biliary obstruction, pain and gastric outlet obstruction (GOO). For obstructive jaundice, surgical treatment should de consider in recurrent stent complications. The role of surgery for pain relief is marginal nowadays. On the last, there is no consensus for treatment of malignant GOO. Endoscopic duodenal stents are associated with shorter length of stay and faster relief to oral intake with more recurrent symptoms. Surgical gastrojejunostomy shows better long-term results and lower re-intervention rates, but there are limited data about laparoscopic approach. We performed a systematic review of the literature, according PRISMA guidelines, to search for articles on laparoscopic gastrojejunostomy for malignant GOO treatment. We also report our personal series, from 2009 to 2017. A review of the literature suggests that there is no standardized surgical technique either standardized outcomes to report. Most of the studies are case series, so level of evidence is low. Decision-making must consider medical condition, nutritional status, quality of life and life expectancy. Evaluation of the patient and multidisciplinary expertise are required to select appropriate approach. Given the limited studies and the difficulty to perform prospective controlled trials, no study can answer all the complexities of malignant GOO and more outcome data is needed.

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“…Some studies have favored stents over surgery. [11][12][13][14][15][16] Some studies have favored surgery over stents. 17,18 Many studies have been relative toss-ups, showing that both approaches have merit, often making the argument that healthier patients with a longer anticipated lifespan should undergo surgery, while more compromised patients with a shorter anticipated lifespan might be best treated via stents.…”

mentioning

confidence: 99%

Should Patients With Malignant Gastric Outlet Obstruction Receive Stents or Surgery?

Adler

2019

Clinical Gastroenterology and Hepatology

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Gastrojejunostomy versus duodenal stent placement for gastric outlet obstruction in patients with unresectable pancreatic cancer

Cited by 38 publications

References 21 publications

Palliative therapy in pancreatic cancer—interventional treatment with stents

Palliative therapy in pancreatic cancer—interventional treatment with stents

Laparoscopic gastrojejunostomy for gastric outlet obstruction in patients with unresectable hepatopancreatobiliary cancers: A personal series and systematic review of the literature

Should Patients With Malignant Gastric Outlet Obstruction Receive Stents or Surgery?

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