Endoscopic Metal-Stent Implantation For Palliative Treatment Of Malignant Duodenal Stenosis

Purpose - To evaluate the efficacy of through-the-scope metal stents for palliation of malignant duodenal stenosis.Material and methods - Fourty two patients with malignant primary Or secondary duodenal stenoses who were treated with the-scope metal stent were analysed. When obstructive jaundice occurred either before, during, or after the initial episode of gastrointestinal luminal obstruction, a biliary stent was inserted.Results - Duodenal metal stents were deployed in 40 patients. Endoprosthesis insertion led to restoration of oral intake in 39 patients. The procedure was not associated with morbidity or mortality. During a mean Follow-up of 9.7 weeks, adequate oral intake was maintained in 38/39 cases. Tumour in-growth led to stent occlusion in 4 cases and re-cannulation was obtained by placement of another stent within the original stent. Obstructive jaundice occurred during the course of the illness in 32 patients and was successfully treated with a biliary metal stent in all cases.Conclusions - Endoscopically placed metal stents offer an effective, well-tolerated alternative to surgical palliation in case of incurable malignant obstruction to gastric outflow.