PALLIATION OF MALIGNANT GASTRIC OUTLET OBSTRUCTION WITH SELF-EXPANDING METAL STENTS

Background and Study Aims: Self-expanding metal stents have long been used in the management of patients with malignant eosphageal and malig nant biliary obstruction, The aim of the present study was to report o n the palliation of malignant gastric outlet obstruction using self-ex panding endoprostheses. Patients and Methods: Between March 1993 and D ecember 1994, 12 patients (eight women, four men, mean age 64 years) s uffering from malignant gastric outlet obstruction due to recurrent ga stric carcinoma (seven patients) and pancreatic head carcinoma (five p atients) presented with an inability to eat and intractable vomiting, The patients were managed with peroral insertion of self-expanding met al stents. Results: Peroral introduction of the stent with the aid of a stabilizing overtube was successful in all patients, with the stent being supported as it was being advanced through the stenosis, Proper release of the stent into the stenotic area was achieved in all cases, relieving the intractable vomiting, The procedure was accomplished wi thout any complications. All patients were able to eat semisolid food four days after the stent insertion, Apart from an asymptomatic partia l stent occlusion in one patient, no other complications were seen dur ing the shortterm follow-up one, two, and three months after discharge , Conclusions: These preliminary results suggest that self-expanding s tents can effectively relieve malignant gastric outlet obstruction.