Palliative treatment of malignant gastroduodenal obstruction: Applications of self-expandable metal stent

Background/aims: The aim of this study was to evaluate the efficacy, effects on survival and complications of self-expandable metal stent applications in patients with malignant gastroduodenal obstruction. Methods: Twenty-five patients undergoing metal stent insertion due to malignant gastroduodenal obstruction between February 2005 and July 2009 were included in the present study. In all patients, self-expandable metal stent 22 mm in diameter was inserted under scopic guidance. The patients were evaluated regarding age, gender, etiology, efficacy of stent insertion, complications, and duration of patency of the stent. Results: Of the 25 patients included in the study, 15 were female and 10 were male. Their mean age was 65.9 years (57-81 years). The most common etiological causes were duodenal tumor (n=10, 40%) and pancreatic tumor (n=8, 32%). Duodenal stent was inserted successfully in all patients. In 4 patients, percutaneous biliary metal stent was inserted at the same time due to concomitant obstructive jaundice. No mortality occurred during the procedure. A second stent was inserted in 4 patients due to stent migration. The patients were followed for a mean of 92 days (7 to 258 days) after the procedure. The stents remained clinically patent in all patients during the follow-up period until death. Conclusions: Insertion of duodenal metal stent is an effective and safe therapeutic approach in the palliative treatment of malignant gastric outlet obstruction.