J Korean Soc Radiol.  2020 Sep;81(5):1175-1183. 10.3348/jksr.2019.0118.

Percutaneous Transgastric Stent Placement for Malignant Gastroduodenal Obstruction

• Cho B
• Jung GS
• Yun JH

• KMID: 2507437
• DOI: http://doi.org/10.3348/jksr.2019.0118

Abstract

Purpose
To evaluate the technical feasibility and clinical efficacy of percutaneous transgastric stent placement after the failure of treatment attempt with the transoral approach in malignant gastroduodenal obstruction patients.
Materials and Methods
From October 2008 to April 2016, nine patients (M:F = 4:5; mean age = 66 years) with malignant gastroduodenal obstruction underwent stent placement via a gastrostomy tract, which was attributed to the failure of the transoral approach. The primary etiologies of the obstruction were pancreatic (n = 5), gastric (n = 2), and metastatic (n = 2) cancers. Through percutaneous gastrostomy, dual stents (inner bare metal and outer polytetrafluoroethylene-covered) were deployed at the obstruction site. The technical and clinical success rates, as well as complications were evaluated during the follow-up period.
Results
Stents were successfully inserted in eight patients (88%). We failed to insert stent in one patient due to the presence of a tight obstruction. After stent placement, symptoms improved in seven patients. Gastrostomy tube was removed 9 to 20 days (mean = 12 days) after the stent insertion. During the mean follow-up of 136 days (range, 3–387 days), one patient developed a recurrent symptom due to tumor overgrowth. However, there were no other major complications associated with the procedure.
Conclusion
Percutaneous transgastric stent placement appeared to be technically feasible and clinically effective in patients who underwent a failed transoral approach.

Keyword

Intestinal Obstruction; Gastrostomy; Stents