BACKGROUND/AIMS: Controversy exists as to whether endoscopic or minimally invasive/open bypass is superior in cases of malignant gastric outlet obstruction. METHODS: Retrospective observational study following those patients admitted to the hospital between January 1999 and December 2004 (n = 23) with gastric outlet obstruction. In all suitable patients endoscopic stent insertion was attempted. Symptomatic improvement was monitored as was time until discharge as well as need for readmission. We also recorded morbidity and mortality associated with the procedure as well as final survival in days. RESULTS: Stents were inserted successfully in 21 patients. Two patients went on to have a laparoscopic bypass. Stent placement relieved obstructive symptoms in all patients. A median inpatient stay of 4 days was achieved (range 2-9 days). One patient was admitted with recurrent symptoms 9 months following his initial treatment. Investigation showed the distal end of the stent to be occluded by further tumor. His symptoms were relieved by the insertion of a second stent. In 19 patients death was due to metastatic disease. Operative mortality: cerebrovascular accident day 2 (n = 1), duodenal perforation day 4 (n = 1). CONCLUSION: Patients with malignant gastric outlet obstruction not suitable for resection should be assessed for insertion of an enteral stent.
BACKGROUND/AIMS: Controversy exists as to whether endoscopic or minimally invasive/open bypass is superior in cases of malignant gastric outlet obstruction. METHODS: Retrospective observational study following those patients admitted to the hospital between January 1999 and December 2004 (n = 23) with gastric outlet obstruction. In all suitable patients endoscopic stent insertion was attempted. Symptomatic improvement was monitored as was time until discharge as well as need for readmission. We also recorded morbidity and mortality associated with the procedure as well as final survival in days. RESULTS: Stents were inserted successfully in 21 patients. Two patients went on to have a laparoscopic bypass. Stent placement relieved obstructive symptoms in all patients. A median inpatient stay of 4 days was achieved (range 2-9 days). One patient was admitted with recurrent symptoms 9 months following his initial treatment. Investigation showed the distal end of the stent to be occluded by further tumor. His symptoms were relieved by the insertion of a second stent. In 19 patientsdeath was due to metastatic disease. Operative mortality: cerebrovascular accident day 2 (n = 1), duodenal perforation day 4 (n = 1). CONCLUSION:Patients with malignant gastric outlet obstruction not suitable for resection should be assessed for insertion of an enteral stent.
Authors: Jin Won Mo; Young Min Kim; Jie-Hyun Kim; Seung Yong Shin; Young Hoon Youn; Hyojin Park Journal: Medicine (Baltimore) Date: 2020-05-22 Impact factor: 1.817