EXPANDABLE METALLIC PROSTHESES FOR MALIGNANT OBSTRUCTIONS OF GASTRIC OUTLET AND PROXIMAL SMALL-BOWEL

Background: Data are limited on use of expandable metal stents for tre atment of malignant gastric outlet obstruction. Accordingly, we report our experience using these stents to palliate malignant obstructions of the gastric outlet, duodenum, and proximal jejunum. Methods: Eight patients with malignant strictures causing gastric obstruction underwe nt endoscopy with fluoroscopic guidance to delineate tumor borders and length followed by expandable metallic prosthesis placement (Wallsten t, Z-Stent, Ultraflex, and Endocoil). Results: Symptoms were relieved in seven patients, five of whom had previous surgeries (Whipple, Billr oth II, esophagojejunostomy, and gatrojejunostomy) for malignancy. One patient underwent surgical resection of a presumed malignant strictur e containing a previously placed Wallstent after a 45-pound weight gai n. Conclusions: Expandable metallic prostheses placed in patients with malignant obstruction of the gastric outlet, duodenum, or proximal je junum, before or after surgery, effectively palliate obstructive sympt oms and may also serve to improve nutrition.