Metallic Stent Placement in the Palliative Treatment of Malignant Gastric Outlet Obstructions: Primary Gastric Carcinoma Versus Pancreatic Carcinoma

Abstract

Metallic stent placement was clinically effective in the palliative treatment of gastric outlet obstruction in patients with gastric and pancreatic carcinoma. The two groups differed significantly in the rates of stent collapse and serious complications and patient survival after stent placement.

Enteral stent construction: Current principles

“…Occasionally, stents do not expand sufficiently or collapse again. 8,17 In these cases, balloon dilatation may be considered, although it may be better to insert a second stent to strengthen the system and ensure an adequate lumen.…”

Malignant Gastric Outlet Obstructions: Treatment with Self-Expandable Metallic Stents

“…[1][2][3][4][5][6][7][8][9][10][11][12] Placement of self expandable metallic stents is associated with higher clinical success rates, less morbidity, shorter times from the procedure to starting oral intake, lower rates of delayed gastric emptying, and shorter hospital stay than palliative surgery. 13,14 This article reviews the use of this minimally-invasive therapeutic option in the palliative treatment of unresectable malignant GOOs.…”

“…The recent introduction of dual-design stents, composed of an outer, partially covered stent and an inner bare stent or an outer bare stent and an inner, fully covered stent, has resulted in low rates of stent migration and resistance to tumor ingrowth. 2,6,12,18 Other authors have introduced a new duodenal bare metallic stent, through which biliary stenting is safe and effective, for the palliative treatment of malignant biliary and duodenal obstruction. 19 Different types of covering materials have been utilized to cover expandable metallic stents, including polyurethane, silicone rubber, and nylon.…”

“…19 Different types of covering materials have been utilized to cover expandable metallic stents, including polyurethane, silicone rubber, and nylon. 2,6,16,20,21 Disruption of the covering membrane may lead to tumor ingrowth, 20 with polyurethane membranes in the gastroduodenal area being particularly susceptible to chemical degradation after exposure to acidic gastric fluid, bile salts, and certain hydrolytic enzymes in pancreatic secretions.…”

“…[1][2][3] The primary goal of treatment in these patients is palliation of obstructive symptoms, thereby improving quality of life. 4 Although palliative surgical procedures have been traditionally performed, they are associated with high rates of morbidity and mortality, due to advanced disease and poor general condition.…”