Self-Expandable Metal Stents in the Treatment of Antro-Pyloric And/or Duodenal Strictures

• Published in: Acta radiologica (1987) 2001-03, Vol.42 (2), p.176-180
• Main Authors: Profili, S., Meloni, G.B., Bifulco, V., Conti, M., Feo, C.F., Canalis, G.C.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Constriction, Pathologic; Digestive System Neoplasms - complications; Diseases of the digestive system; Duodenal Diseases - diagnostic imaging; Duodenal Diseases - therapy; Female; Humans; Male; Medical sciences; Middle Aged; Pyloric Antrum; Pyloric Stenosis - diagnostic imaging; Pyloric Stenosis - therapy; Radiography; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Stents
• ISSN: 0284-1851; 1600-0455
• DOI: 10.1080/028418501127346477

AbstractPurpose: To assess the usefulness of self-expandable metal stents in the recanalization of antro-pyloric and/or duodenal strictures.Material and Methods: We report our experience of 15 patients with inoperable antro-pyloric and/or duodenal strictures treated by implantation of 21 self-expandable metal stents (18 uncovered and 3 covered) inserted perorally under fluoroscopic guidance. The patients were 11 men and 4 women, mean age 65.3 years. Fourteen of 15 patients were affected by a malignant stricture of the antro-pyloric region and/or duodenum either primary or secondary in 10 and 4 cases, respectively. Only in 1 case there was a benign stricture from postoperative scarring. Stricture length and diameter varied from 3 to 9 cm (mean 5.4 cm) and from 0 to 4 mm (mean 1.27 mm), respectively.Results: Twenty-one stents were placed in 15 patients: Technical success was achieved in all cases while clinical improvement was obtained in 14 cases. No short-term complications were observed. A mean 4.3-month follow-up was obtained. Two patients had emesis secondary to peritoneal dissemination of the tumor after 1 and 2 months, respectively. Two other patients showed tumor overgrowth of the oral edge of the prosthesis after 3 and 2 months, respectively, and required another coaxial stent to bridge the new stenosis. The patient treated for a benign stricture had jaundice after 3 months and percutaneous internal-external biliary drainage was necessary.Conclusion: Self-expandable metal stents are a safe and effective treatment of antro-pyloric and duodenal strictures; therefore, they should be considered an alternative to palliative resection in cases of advanced stage disease or poor general physical condition.