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a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2018; 72(5): 408–414. doi:10.14735/amgh2018408.

Self-expanding duodenal stents, palliative treatment of gastric outlet obstruction in malignant disease

Ján Ušák  1, Filip Závada  2, Rastislav Husťak3,4,5, Andrej Klepanec6, Igor Keher7, Silvia Hojerová8, Marián Streško9, Vanda Ušáková10, Jan Martínek  11,12

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Background: Endoscopic self-expandable metallic stent (SEMS) placement for gastric outlet obstruction caused by either intrinsic or extrinsic obstruction of the pylorus or duodenum is an elective palliative procedure for high-risk surgical patients. Pancreatic and/or gastric carcinoma are often diagnosed at an advanced stage when the incidence of poor nutritional status is high and SEMS placement has the potential of providing the best supportive care. Aim: To evaluate our first experience with SEMS for palliation of malignant gastric outlet obstruction measured by gastric outlet obstruction score and to assess the survival rate of patients undergoing this treatment. Method: Retrospective analysis was performed at a tertiary center between 2013 and 2017 to assess overall patient survival after SEMS placement that allowed patients to the leave hospital quickly and return to daily activity. The mean age of the patients was 69.5 years. Twenty-six duodenal stents were implanted in 20 patients, who had been diagnosed with pancreatic and gastric cancer with a low performance status, making them unfit for surgery. Average survival was 114.6 day after duodenal stenting and 65% of patients were discharged. Conclusion: The right indication and correct placement of SEMS into the duodenum may effectively solve malignant gastric outlet obstruction, leading to improvements in quality of life in end-stage malignant disease.


duodenal stent, gastric outlet obstruction, supportive care, self-expandable metallic stent

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