Clinical Trials Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2016; 22(14): 3837-3844
Published online Apr 14, 2016. doi: 10.3748/wjg.v22.i14.3837
Endoscopic management of unresectable malignant gastroduodenal obstruction with a nitinol uncovered metal stent: A prospective Japanese multicenter study
Reina Sasaki, Yuji Sakai, Toshio Tsuyuguchi, Takao Nishikawa, Tatsuya Fujimoto, Shigeru Mikami, Harutoshi Sugiyama, Osamu Yokosuka
Reina Sasaki, Yuji Sakai, Toshio Tsuyuguchi, Takao Nishikawa, Harutoshi Sugiyama, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Tatsuya Fujimoto, Department of Gastroenterology, Kimitsu Chuo Hospital, Chiba 260-8670, Japan
Shigeru Mikami, Department of Gastroenterology, Kikkoman General Hospital, Chiba 260-8670, Japan
Author contributions: Sasaki R contributed to collection, organization, analysis, and interpretation of data, and drafting of the manuscript; Sakai Y contributed to conception and design of the study; Tsuyuguchi T final approvaled the manuscript; Nishikawa T critical revision of technical content; Fujimoto T, Mikami S, Sugiyama H and Yokosuka O contributed to collection and organization of data.
Institutional review board statement: This study was conducted under approval our ethical committee.
Clinical trial registration statement: Medical Information Network Clinical Trial Registry (ID: UMIN000005112).
Informed consent statement: All the treatment procedures were performed after obtaining the informed consent in writing from the patients.
Conflict-of-interest statement: The authors have no other disclosures.
Data sharing statement: I share data in the group of us.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yuji Sakai, MD, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. sakai4754@yahoo.co.jp
Telephone: +81-43-2262083 Fax: +81-43-2262088
Received: January 23, 2016
Peer-review started: January 23, 2016
First decision: February 18, 2016
Revised: February 25, 2016
Accepted: March 14, 2016
Article in press: March 14, 2016
Published online: April 14, 2016
Processing time: 66 Days and 8.6 Hours
Abstract

AIM: To determine the safety and efficacy of endoscopic duodenal stent placement in patients with malignant gastric outlet obstruction.

METHODS: This prospective, observational, multicenter study included 39 consecutive patients with malignant gastric outlet obstruction. All patients underwent endoscopic placement of a nitinol, uncovered, self-expandable metal stent. The primary outcome was clinical success at 2 wk after stent placement that was defined as improvement in the Gastric Outlet Obstruction Scoring System score relative to the baseline.

RESULTS: Technical success was achieved in all duodenal stent procedures. Procedure-related complications occurred in 4 patients (10.3%) in the form of mild pneumonitis. No other morbidities or mortalities were observed. The clinical success rate was 92.3%. The mean survival period after stent placement was 103 d. The mean period of stent patency was 149 d and the patency remained acceptable for the survival period. Stent dysfunction occurred in 3 patients (7.7%) on account of tumor growth.

CONCLUSION: Endoscopic management using duodenal stents for patients with incurable malignant gastric outlet obstruction is safe and improved patients’ quality of life.

Keywords: Duodenal stenosis; Gastrointestinal stent; Gastric stenosis; Malignant tumors; Metallic stent

Core tip: Endoscopic management using duodenal stents for patients with incurable malignant gastric outlet obstruction is safe and improved patients’ quality of life.