A Case of Endoscopic Temporary Stent Insertion to Treat a Pyloric Stenosis Caused by Endoscopic Submucosal Dissection for Early Gastric Cancer

Lee, Won Woo; Park, Jong Jae; Oh, Cho Rong; Nam, Seung Joo; Kim, Key Hyeon; Hwang, Jin Ki; Kim, Jae Seon; Bak, Young Tae

Abstract

Circumferential resection by performing endoscopic submucosal dissection (ESD) in the antrum can cause pyloric stenosis. Treatment with balloon dilation usually requires repeated sessions and this may cause bleeding or perforation. There are several studies regarding the treatment of benign pyloric stenosis by the temporary placement of self-expandable metallic stent (SEMS), but these studies did not include any case of pyloric stenosis caused by ESD for treating early gastric cancer (EGC). We experience a case of a man who had EGC encircling the antrum. After ESD, pyloric stenosis occurred and so a SEMS was applied. Eight weeks later, the stent was removed without complications. Stent insertion for benign pyloric stenosis has not been accepted as a standard therapeutic modality. However, continuous dilation of a stenotic lesion can be expected without major complications, except for migration. Therefore, temporary stent insertion can be considered as an alternative treatment option for benign pyloric stenosis. Further study on the long term outcome of this procedure is needed.