Endoscopic treatment of neoplastic enteral obstruction by means of self-expanding metal stents

Abstract

BACKGROUND: Neoplastic gastroduodenal inoperable stenosis require a palliative treatment to restore alimentary transit.

OBJECTIVE: Our purpose was to treat neoplastic gastroduodenal stenosis with self-expanding enteral stents.

MATERIAL OF STUDY: An endoscopic treatment with uncovered self-expanding metal stents has been performed in 45 patients: 37 duodenal stenosis (34 pancreatic neoplasia, 1 gallbladder neoplasia, 2 peritoneal carcinosis), 5 anthropyloric neoplastic stenosis and 3 gastro-jejunal anastomosis stenosis were treated. A total of 47 metal stent were positioned: in 43 patient 1 stent; in 2 patient, with a long stenosis, 2 stents. Main Outcome Measurement: Efficacy of endoscopic treatment to restore alimentary transit.

RESULTS: The positioning was successfull in all cases without any complication. All patients had a rapid and satisfying recovery from symptoms connected to the obstruction. The hospitalization period was averagely 3 days (range 1-7). In one patient another stent was inserted 2 months later because of tunoral ingrowth. The median survival period was 4 months (range 1-5). In one patient with duodenal stenosis due to pancreatic neoplasia,in which were inserted 2 stents, distal one dislocated in the jejunum 3 months later. It was removed by surgery.

CONCLUSIONS: The endoscopic stenting is a valid treatment of inoperable gastric duodenal stenosis and may become the preferable option for the palliative treatment of this pathology.