Palliation of malignant gastric outlet obstruction caused by gastric cancer with self-expandable metal stents

Gastric carcinoma is among the most common cancers worldwide. Surgery remai ns the mainstay of potentially curative treatments. Unfortunately, most pat ients have an advanced form of the disease. We evaluated our experience in palliating malignant gastric outlet obstruction caused by gastric cancer wi th expandable metal stents (Wallstent Enteral; Boston Scientific, Singapore ). Six patients with a median age of 68 years (range, 45-88) underwent the procedure. Three had metastatic gastric cancer; two recurrent gastric cance r; and one locally advanced gastric cancer with poor comorbid status. After the procedure, five of the six patients were able to resume an oral feedin g within 24 hours. One patient with gastric dysmotility caused by linitus p lastica required nasogastric tube feeding. Three patients died during a med ian followup period of 4 weeks (range, 2-8). The other three patients were still well at a median follow-up period of 10 weeks (range, 5-12). There wa s no procedure-related mortality or morbidity, nor was there any stent migr ation or blockage in any of these patients. In conclusion, palliation of ma lignant gastric outlet strictures caused by gastric cancer with expandable metal stents is an effective and safe alternative to surgery, particularly in patients with postgastrectomy anastomotic recurrence and in those who ar e poor candidates for surgery. Patients who are not expected to survive bey ond 1 month and those with linitus plastica and associated gastric dysmotil ity may not be appropriate candidates for such a procedure.