Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2018; 24(40): 4578-4585
Published online Oct 28, 2018. doi: 10.3748/wjg.v24.i40.4578
Self-expandable metal stents in patients with postoperative delayed gastric emptying after distal gastrectomy
Seung Han Kim, Bora Keum, Hyuk Soon Choi, Eun Sun Kim, Yeon Seok Seo, Yoon Tae Jeen, Hong Sik Lee, Hoon Jai Chun, Soon Ho Um, Chang Duck Kim, Sungsoo Park
Seung Han Kim, Bora Keum, Hyuk Soon Choi, Eun Sun Kim, Yeon Seok Seo, Yoon Tae Jeen, Hong Sik Lee, Hoon Jai Chun, Soon Ho Um, Chang Duck Kim, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Gastrointestinal Medical Instrument Research, Korea University College of Medicine, Seoul 02841, South Korea
Sungsoo Park, Division of Upper GI Surgery, Department of Surgery, Korea University College of Medicine, Seoul 02841, South Korea
Author contributions: Kim SH, Keum B, and Chun HJ designed the research study; Kim SH and Keum B performed the research; Kim ES, Jeen YT, Lee HS , Kim CD, Park S, Choi HS, Seo YS, and Um SH analyzed the data; and Kim SH wrote the manuscript.
Supported by a Korea University Grant, No. K1809701; and the Ministry of Trade, Industry &Energy (MOTIE, Korea) under the Industrial Technology Innovation Program, No. 10060251; ‘Development of diagnostic device for functional dyspepsia based on Korean-Western medicine fusion abdominal diagnosis’.
Institutional review board statement: The study was reviewed and approved by the Korea University Anam Hospital Institutional Review Board.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no conflicts of interest or financial ties to disclose.
Data sharing statement: No additional data are available.
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: Bora Keum, MD, PhD, Professor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, 126-1, Anam-dong 5 ga, Seongbuk-gu, Seoul 136705, South Korea. borakeum@hanmail.net
Telephone: +82-2-9206555 Fax: +82-2-9531943
Received: July 19, 2018
Peer-review started: July 19, 2018
First decision: August 25, 2018
Revised: September 11, 2018
Accepted: October 5, 2018
Article in press: October 5, 2018
Published online: October 28, 2018
Processing time: 100 Days and 0 Hours
Abstract
AIM

To investigate the efficacy and safety of endoscopic stent insertion in patients with delayed gastric emptying after gastrectomy.

METHODS

In this study, we prospectively collected data from patients who underwent stent placement for delayed gastric emptying (DGE) after distal gastrectomy between June 2010 and April 2017, at a tertiary referral academic center. Clinical improvement, complications, and consequences after stent insertion were analyzed.

RESULTS

Technical success was achieved in all patients (100%). Early symptom improvement was observed in 15 of 20 patients (75%) and clinical success was achieved in all patients. Mean follow-up period was 1178.3 ± 844.1 d and median stent maintenance period was 51 d (range 6-2114 d). During the follow-up period, inserted stents were passed spontaneously per rectum without any complications in 14 of 20 patients (70%). Symptom improvement was maintained after stent placement without the requirement of any additional intervention in 19 of 20 patients (95%).

CONCLUSION

Endoscopic stent placement provides prompt relief of obstructive symptoms. Thus, it can be considered an effective and safe salvage technique for post-operative DGE.

Keywords: Self-expandable metal stent; Delayed gastric emptying; Gastrectomy; Salvage technique; Symptom improvement

Core tip: Delayed gastric emptying (DGE) after distal gastrectomy is a significant postoperative complication, and appropriate treatment measures are not yet available. This retrospective study investigated the efficacy and safety of self-expandable metallic stents in patients with DGE after gastric surgery. We found that endoscopic stent placement provided prompt relief of obstructive symptoms, with a low rate of complications, and no need for additional surgical interventions.