Malignant pyloro-duodenal obstruction: role of self expandable metallic stents

To determine the outcome of duodenal stenting in palliation of patients with malignant pyloric and duodenal obstruction. The non-randomised prospective descriptive study was conducted at the Endoscopy Suite, Surgical Unit-IV, Civil Hospital, Karachi, from December 2007 to November 2010. All patients...

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Bibliographic Details
Published in:Journal of the Pakistan Medical Association 2014-01, Vol.64 (1), p.16-19
Main Authors: Qureshi, Sajida, Ghazanfar, Shahriyar, Hafeez, Abu Bakar, Taj, Mohammad Ali, Niaz, Saad Khalid, Quraishy, Mohammad Saeed
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biliary Tract Neoplasms - complications
Cancer patients
Digestive System Neoplasms - complications
Duodenal Obstruction - etiology
Duodenal Obstruction - therapy
Duodenum
Female
Gallbladder Neoplasms - complications
Gastrointestinal diseases
Health aspects
Humans
Male
Middle Aged
Obstruction
Pancreatic Neoplasms - complications
Prospective Studies
Pylorus
Stent (Surgery)
Stents
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Summary:To determine the outcome of duodenal stenting in palliation of patients with malignant pyloric and duodenal obstruction. The non-randomised prospective descriptive study was conducted at the Endoscopy Suite, Surgical Unit-IV, Civil Hospital, Karachi, from December 2007 to November 2010. All patients presenting with inoperable ampullary, pancreatic or biliary cancers causing duodenal obstruction and patients with resectable malignancy but unfit for surgery were included. The procedure was carried out by a single expert endoscopist under local or general anaesthaesia as required. Boston Scientific stents of variable sizes were used. Follow-up was done at 1 week, 1 month and 6 months. Data analysis was done using SPSS 15. Over the study period, 159 (60%) males and 6 (40%) females were included in the study. The male-to-female ratio was 2:3. The overall age ranged from 25-80 years with a mean of 52.67 +/- 15.07 years. Primary diagnosis was pyloric carcinoma in 7(46.6%), carcinoma Gallbladder in 4(26.6%), Duodenal carcinoma in 3(20%) and carcinoma head of pancreas in 1(6.6%). Relief of symptoms were seen in 11 (73.3%), while complications were seen in 2 (13.3%). Stents were inserted with technical success in 14 (93%) patients. Clinical success was seen in 11 (73%), with a mean survival of 74.27 +/- 40.7 days (range: 15-180 days). No statistical significance was found when comparing the survival time with age, gender and diagnosis. Use of self-expandable metallic stents for gastroduodenal malignancies appears to be a feasible, safe and effective method, especially in those patients with limited life expectancy.
ISSN:0030-9982