PALLIATION OF MALIGNANT GASTRIC AND SMALL-INTESTINAL STRICTURES WITH SELF-EXPANDABLE METAL STENTS

Background: Malignant gastrointestinal obstruction is a common preterm inal event that is often treated surgically. The use of self-expandabl e stents to tl eat malignant gastric and small intestinal strictures i s limited. We evaluated the feasibility; effectiveness, safety and out come of self-expandable metal stents in providing palliative care for patients with inoperable malignant strictures of the stomach and small intestine. Methods: Eleven consecutive patients with complete or near complete gastric or small intestinal obstruction were treated palliat ively with self-expandable metal stents, Contrast radiographs were tak en before and after insertion in all patients to confirm patency. Nine teen stents were placed using biliary guidewires and catheters under e ndoscopic and fluoroscopic guidance. Diets were modified as needed, Su ccess was defined both technically and clinically. Results: Technical and clinical success with improvement in the patient's oral diet nas a chieved in ten patients (91%), The one failure was caused by severe an astomotic angulation and distal luminal obstruction. During the follow -up of 5 to 294 days (mean 77 days) there were no major complications except that the stents occluded in four patients. Conclusion: Palliati on of malignant gastric and small intestinal strictures with self-expa ndable metal stents is a feasible, effective, and safe alternative to operation.