Enteral stents for malignancy

A report of 46 consecutive cases over 10 years, with critical review of complications

Melissa Lapinska, Sonia Gosain, Hugo Bonatti, Charles M. Friel, Kristi Ellen, Patrick G. Northup, Michel Kahaleh

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Current management of malignant gastric outlet obstruction (GOO) includes surgical diversion or enteral stent placement for unresectable cancer. We analyzed the long-term results, predictive factors of outcomes, and complications associated with enteral stents with focus on their management. Methods: Between 1997 and 2007, 46 patients with malignant GOO underwent placement of self-expandable metal stents (SEMS) for palliation. Patients were captured prospectively after 2001 and followed until complication or death. Patency, management of complications, and long-term survival were analyzed. Results: Forty-six patients had a mean survival of 152 ± 235 days and a mean SEMS patency rate of 111 ± 220 days. SEMS patency rates of 98%, 74%, and 57% at 1, 3, and 6 months were seen. Thirteen patients presented with obstruction and included two SEMS migration, two early occlusion, one fracture, four malignant ingrowth, and four with delayed clinical failure. Interventions included seven endoscopic revisions with three SEMS replacements. Six had percutaneous endoscopic gastrostomy with jejunal arm placed. Two patients eventually underwent surgical bypass. Two patients required surgery for complications including delayed duodenal perforation and aortoenteric fistula. Conclusions: SEMS effectively palliate gastric outlet obstructions that result from upper gastrointestinal malignancies. Their benefits offset potential complications or malfunctions, when a pluridisciplinary approach is adopted.

Original languageEnglish (US)
Pages (from-to)2045-2050
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume12
Issue number11
DOIs
StatePublished - Nov 1 2008
Externally publishedYes

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Small Intestine
Stents
Gastric Outlet Obstruction
Neoplasms
Gastrostomy
Survival
Fistula
Self Expandable Metallic Stents

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

Cite this

Enteral stents for malignancy : A report of 46 consecutive cases over 10 years, with critical review of complications. / Lapinska, Melissa; Gosain, Sonia; Bonatti, Hugo; Friel, Charles M.; Ellen, Kristi; Northup, Patrick G.; Kahaleh, Michel.

In: Journal of Gastrointestinal Surgery, Vol. 12, No. 11, 01.11.2008, p. 2045-2050.

Research output: Contribution to journalArticle

Lapinska, Melissa ; Gosain, Sonia ; Bonatti, Hugo ; Friel, Charles M. ; Ellen, Kristi ; Northup, Patrick G. ; Kahaleh, Michel. / Enteral stents for malignancy : A report of 46 consecutive cases over 10 years, with critical review of complications. In: Journal of Gastrointestinal Surgery. 2008 ; Vol. 12, No. 11. pp. 2045-2050.
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