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Annals of Oncology 10:S261-S264, 1999
© 1999 European Society for Medical Oncology

Role of endoscopic stenting in the duodenum

David L. Carr-Locke

Director of Endoscopy, Brighton and Women's Hospital, Associate Professor of Medicine, Harvard Medical School Boston, Massachusetts, USA

Correspondence to: David L. Carr-Locke, MD, FRCP, Director of Endoscopy, Brigham and Women's Hospital, Associate Professor of Medicine, Harvard Medical School, Boston, Massachusetts, USA

Background: Gastric outlet obstruction may cause the presenting symptoms, or may develop during the course of pancreatic or biliary malignancy. Treatment options for malignant gastric outlet obstruction are limited. Surgical gastrojejunostomy is commonly performed, but carries significant morbidity and mortality.

Methods: Over the past two years, we conducted a prospective study to determine the safety, feasibility and outcomes of the newly-designed Wallstent Enteral® (Scneider, Minneapolis, MN) to treat a variety of malignant gastric outlet obstructions. We deployed stents 16 to 22 mm in diameter and 60 to 90 mm in length directly through the endoscope.

Results: Twelve patients (10 women ans 2 men, mean age = 59.7 years) underwent the procedure. After stenting, six patients were able to eat a regular diet, and three were able to eat a pureed diet. In three patients, the procedure was unsuccessful because of multiple obstructions that were not recognized prior to stenting in one and stents that were deployed either too proximally in one or too distally in another. Three patients were discharged within 24 hours after stenting and three had the procedure as an outpatient.

Conclusions: Placement of the Wallstent Enteral through the endoscope is safe and effective palliation for a variety of malignant gastric outlet obstructions, and leads to significant improvement in many aspects of patients' quality of life.

duodenum, endoscopy, stenting


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