Malignant obstruction of gastric outlet and duodenum: Palliation with flexible covered metallic stents

PURPOSE: To assess the usefulness of flexible covered metallic stents in th e palliation of malignant obstruction of the gastric outlet and duodenum. MATERIALS AND METHODS: Twenty-four consecutive patients with malignant obst ruction of the gastric outlet (n = 22) or duodenum (n = 2) underwent pallia tive treatment with self-expandable flexible covered metallic stents. Fourt een patients had advanced gastric carcinoma at the antrum and/or pylorus, a nd eight had obstruction at the anastomosis site of previous gastrojejunost omy. Complications and clinical status were investigated during the study p eriod. RESULTS: The technical success rate was 75% (18 of 24 patients). Twenty-one stents were placed in 18 patients by using an introducer 6 (n = 7) or 8 mm (n = 14) in diameter. The mean follow-up period was 3.4 months (range, 1 w eek to 9 months). Symptoms improved in 12 (67%) patients after the procedur e. There was no change in symptoms in five and a decrease in one. Twelve pa tients died during the follow-up period (mean survival, 4.3 months). The co mplication rate was 25% (six of 24 patients), including stent migration (n = 5) and fracture (n = 3). CONCLUSION: Flexible covered metallic stent placement can be useful for pal liation in patients with malignant obstruction of the gastric outlet or duo denum.