Relief of malignant duodenal obstruction by percutaneous insertion of a metal stent

Keymling, Michael; Wagner, Hans‐Joachim; Vakil, Nimish; Knyrim, K.

doi:10.1016/s0016-5107(93)70125-x

Cited by 76 publications

(44 citation statements)

References 8 publications

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“…12,13 However permanent external drainage is a very unsatisfactory outcome, leaving the patient disfigured by a drainage bag full of bile and the carers with the challenge of maintaining it. Reports of transhepatic placement of enteral stents are rare [14][15][16][17][18] and we have only found one previous case of direct percutaneous enteral stent insertion for Roux loop obstruction. 7 With adoption of techniques used for other interventions it should be possible to achieve internal drainage in most cases, but a number of careful considerations are required.…”

Section: Discussionmentioning

confidence: 85%

Obstructive Jaundice after Bilioenteric Anastomosis: Transhepatic and Direct Percutaneous Enteral Stent Insertion for Afferent Loop Occlusion

Laasch

2010

Gut Liver

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Recurrent tumour after radical pancreaticoduodenectomy may cause obstruction of the small bowel loop draining the liver. Roux-loop obstruction presents a particular therapeutic challenge, since the postsurgical anatomy usually prevents endoscopic access. Careful multidisciplinary discussion and multimodality preprocedure imaging are essential to accurately demonstrate the cause and anatomical location of the obstruction. Transhepatic or direct percutaneous stent placement should be possible in most cases, thereby avoiding long-term external biliary drainage. Gastropexy T-fasteners will secure the percutaneous access and reduce the risk of bile leakage. The static bile is invariably contaminated by gut bacteria, and systemic sepsis is to be expected. Enteral stents are preferable to biliary stents, and compound covered stents in a sandwich construction are likely to give the best long-term results. Transhepatic and direct percutaneous enteral stent insertion after jejunopexy is illustrated and the literature reviewed. (Gut Liver 2010; 4(Suppl. 1):S89-95)

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Section: Discussionmentioning

confidence: 85%

Obstructive Jaundice after Bilioenteric Anastomosis: Transhepatic and Direct Percutaneous Enteral Stent Insertion for Afferent Loop Occlusion

Laasch

2010

Gut Liver

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“…Thus it was made possible the relief of obstruction of digestive tract by non-surgical procedures. Karnel et al [48] , Goldrn et al [49] , Keymling et al [50] and others had respectively tried to use metallic intraluminal stent in treating colonic, biliary and duodenal obstruction. Their success had laid the basis of the expanded use of digestive tract intraluminal stent.…”

Section: Significance and Technical Difficultiesmentioning

confidence: 99%

Treatment of malignant digestive tract obstruction by combined intraluminal stent installation and intra-arterial drug infusion

Mao¹

2001

WJG

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AIM To study the palliative treatment of malignant obstrution of digestive tract with placement of intraluminal stent combined with intra-arterial infusion of chemotherapeutic drugs.METHODS A total of 281 cases of digestive tract malignant obstruction were given per oral (esophagus, stomach, duodenum and jejunum), per anal (colon and rectum) and percutaneous transhepatic (biliary) installation of metallic stent. Among them, 203 cases received drug infusion by cannulation of tumor supplying artery with Seldinger's technique. RESULTSAltogether 350 stents were installed in 281 cases, obstructive symptoms were relieved or ameliorated after installation. Occurrence of restenotic obstruction was 8-43 weeks among those with intraarterial drug infusion, which was later than 4-26 weeks in the group with only stent installation. The average survival time of the former group was 43 (3-105) weeks, which was significantly longer than 13 (3-24) weeks of the latter group.CONCLUSION Intraluminal placement of stent combined with intra-arterial infusion chemotherapy is one of the effective palliative therapies for malignant obstruction of the digestive tract with symptomatic as well as etiological treatment.

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“…SEMS placement for gastric tumors can sometimes be very diffi cult due to the anatomical angulation of the stomach and gastroduodenal lumen, leading to diffi culties in stent deployment, and is therefore not very widely used [24] . Stent placement was initially performed via gastrostomy or by using esophageal SEMS or biliary Wallstents with a small diameter [25] .…”

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confidence: 99%

Endoscopic Palliation and Nutritional Support in Advanced Gastric Cancer

Dormann

2004

Dig Dis

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Most of the patients with advanced gastric cancer have incurable disease at presentation and require palliative treatment to reduce symptoms as vomiting, nausea and inability to eat. Treatment options are palliative surgery and endoscopic techniques. Insertion of self-expanding metal stents is nowadays a well-established method of treating biliary and esophageal strictures and is also effective in gastric tumors. The indication and application technique are described in this review. In addition, enteral nutrition is indicated if the gastrointestinal tract functions but swallowing or mastication is compromised by disease or if it is needed to pass an obstructed area, especially in gastric tumor patients. This article reviews the enteral nutrition techniques and their clinical value for patients with advanced gastric cancer.

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Relief of malignant duodenal obstruction by percutaneous insertion of a metal stent

Cited by 76 publications

References 8 publications

Obstructive Jaundice after Bilioenteric Anastomosis: Transhepatic and Direct Percutaneous Enteral Stent Insertion for Afferent Loop Occlusion

Obstructive Jaundice after Bilioenteric Anastomosis: Transhepatic and Direct Percutaneous Enteral Stent Insertion for Afferent Loop Occlusion

Treatment of malignant digestive tract obstruction by combined intraluminal stent installation and intra-arterial drug infusion

Endoscopic Palliation and Nutritional Support in Advanced Gastric Cancer

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