Self-Expandable Metallic Stent in Malignant Gastroduodenal Outlet Obstruction: A Viable Alternative?

Aims Malignant gastroduodenal outlet obstruction (GOO) is commonly seen with distal gastric cancer and pancreatic adenocarcinoma with extension to the duodenum or stomach (1). Gastroenterostomy has been the mainly treatment strategy for this condition, however, is associated with high mortality and many patients are excluded from surgery because of poor medical condition (2). Self-expanding metallic stents (SEMS) are an increasingly used alternative. We aimed to evaluate the effectiveness and safety of this technique in palliation of malignant GOO.

Methods We retrospectively assessed 43 patients with mean age 72 ± 15.6 years, in whom the SEMS was placed, between January 2012 and December 2019. All of them had unresectable cancer. SEMS were placed under fluoroscopic guidance. We assessed technical and clinical success, median survival and the need for re-intervention. Clinical success was evaluated through the food tolerance after stent placement, according to gastric outlet obstruction scoring system (GOOSS).

Results In our sample, 60,4 % of patients had gastric cancer, 25,6 % had pancreatic cancer and 14 % other neoplasms. We achieved 100 % technical success and 95,3 % clinical success. After the procedure, 10 patients (23,3 %) had a GOOSS 1 and 30 patients (70 %) had at least GOOSS ≥ 2. Survival at 30 days was 53.5 % and median survival after the procedure was 81 ± 13 days. There was a need to place a second stent in 11 patients (25,6 %), with no need for surgical intervention.

Conclusions SMES seem to be an effective and safe alternative in GOO in patients undergoing paliative care.

Citation: Pereira Correia F, Alexandrino G, Branco JC et al. eP186 SELF-EXPANDABLE METALLIC STENT IN MALIGNANT GASTRODUODENAL OUTLET OBSTRUCTION: A VIABLE ALTERNATIVE?. Endoscopy 2021; 53: S157.

Publication History

Article published online:
19 March 2021