Enteral stenting versus gastrojejunostomy for palliation of malignant gastric outlet obstruction

Khashab, Mouen A.; Alawad, Ahmad S.; Shin, Eun Ji; Kim, Katherine; Bourdel, Nicolas; Singh, Vikesh K.; Lennon, Anne Marie; Hutfless, Susan; Sharaiha, Reem Z.; Amateau, Stuart K.; Okolo, Patrick I.; Makary, Martin A.; Wolfgang, Christopher L.; Canto, Marcia I.; Kalloo, Anthony N.

doi:10.1007/s00464-012-2712-7

Cited by 144 publications

(143 citation statements)

References 29 publications

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“…36 Another option in widespread use is endoscopic placement of an enteral self-expanding metal stent (SEMS), which have high technical (90%-100%) and clinical success rates (67%-100%). 37,38 However, SEMS can become obstructed or overgrown by tumor resulting in reduced luminal patency (57% in one study) after 6 months. 39 With the recent development of LAMS, Tyberg et al 40 examined the utility of LAMS for EUS-guided GJ (EUS-GJ) in patients with benign and malignant GOO.…”

Section: Other Procedures: Gastrojejunostomy Eus-directed Transgastrmentioning

confidence: 99%

Lumen apposing metal stents: A review of current uses and outcomes

Bank

Adler

2017

Int J Gastrointest Interv

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A B S T R A C TLumen-apposing metal stents (LAMS) represent a new innovation in gastrointestinal endoscopy. These devices have a saddle-shaped design and larger inner lumen diameter than either plastic or metal biliary stents, which should decrease the risk of migration and allows for an endoscope to pass into pancreatic fluid collections as well as the ability to perform direct endoscopic necrosectomy. LAMS were originally conceived and designed for transmural pancreatic fluid collection drainage but are currently also being used for many off label indications. There are three different LAMS available at this time around the globe. This manuscript will review the current state of the art with regards to LAMS and their indications, usage, and outcomes.

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Section: Other Procedures: Gastrojejunostomy Eus-directed Transgastrmentioning

confidence: 99%

Lumen apposing metal stents: A review of current uses and outcomes

Bank

Adler

2017

Int J Gastrointest Interv

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“…A klasszikus sebészeti palliáció -gastroenteroanastomosis -mellett vagy helyett hazánkban is egyre több endoszkópos centrumban válik gyakorlattá az enteralis stenttel történő endoszkópos palliáció [3,4,5]. [1,6,7]: -öntágulós fedetlen fémstent, -fedett fémstent [8], -részlegesen fedett, úgynevezett "big cup" Hanaro DPC-stent [9], -60-80-100-120-140 mm hossz-és 18-20-22-24 mm átmérőméretek.…”

Section: Eredeti Közleményunclassified

“…A stenttartósság hosszabbnak bizonyult, mint a várható túlélés. Ezt a nemzetközi irodalmi adatok is alátámasztják, amelyek alapján a stenttartósságot 190-385 nap közöttinek, az átlagos túlélést pedig 49-182 nap közöttinek találták [2,3,4].…”

Section: Táblázatunclassified

Malignus gastroduodenalis obstrukció endoszkópos palliációja fedetlen enteralis stenttel

et al. 2015

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Bevezetés: A malignus gastroduodenalis obstrukció palliatív kezelése enteralis stentekkel hatékony és biztonságos módszer, a palliatív céllal elkészített gastroenterostomia reális alternatívája. Célkitűzés: A szerzők ismertetik a malignus gastroduodenalis obstrukció hátterében fennálló leggyakoribb daganatos betegségeket, a stent kiválasztásának szempontjait, behelyezési technikáját, valamint elemzik a kezelés technikai és klinikai sikerességét, megemlítve a lehetséges komplikációkat. Módszer: 2013. március 1. és 2015. április 9. között 19 esetben történt fedetlen, öntágulós enteralis stentbehelyezés. A 19 beteg közül 6 nő, 13 férfi , átlagéletkoruk 67 év volt. A stentelés indikációját 5 esetben peripyloricus gyomortumor, 1-1 esetben a duodenum, gastroenteralis anastomosis, Vater-papilla és az epehólyag malignus folyamata, 7 esetben pancreas, 3 esetben az epeút tumora képezte. Eredmények: A stentbehelyezés technikai sikeressége 100%-os volt. A klinikai siker objektivizálása a Gastric Outlet Obstruction Scoring System alapján történt. Következtetések: Az enteralis stentek alkalmazása malignus gastroduodenalis obstrukcióban technikailag jól kivitelezhető, biztonságos módszer, amely látványosan csökkenti a betegség tüneteit, javítja az életminőséget. Orv. Hetil., 2015, 156(44), 1778-1781.Kulcsszavak: enteralis stent, malignus gastroduodenalis obstrukció, stentbehelyezés, duodenumszűkület Palliative endoscopic treatment of malignant gastroduodenal obstructions with uncovered enteral stentsIntroduction: Palliative treatment of malignant gastroduodenal obstructions with enteral stents is an effective and safe method, and a viable alternative to gastroenterostomy. Aim: The authors present the most common malignancies behind gastroduodenal obstructions, the aspects of stent selections, insertion techniques, technical and clinical success rates, and possible procedure-related complications. Method: Between 1 March, 2013 and 9 April, 2015 nineteen patients were treated with uncovered, self-expandable enteral stents. Out of the 19 patients, 6 were females and 13 males, with an average age of 67 years. Indications of stenting were peripyloric ventricular tumour in fi ve cases, malignancies of the duodenum, gastroenteralis anastomosis, Vater papilla and gallbladder in one case respectively, pancreatic tumor in seven cases and bile duct malignancies in three cases. Results: The technical success rate of stent placement was 100%. The evaluation of clinical success was analised on the basis of the Gastric Outlet Obstruction Scoring System. Conclusions: The use of enteral stents in malignant gastroduodenal obstructions is a reliable and safe method, which promptly decreases symptoms of the patients and improves their quality of life.

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“…Most studies agree that stenting provides the following advantages over laparoscopic or open gastro-jejunostomy: shorter operative time, shorter hospital stay and decreased time to oral intake [44][45][46][47][48][49][50][51][52]. However, they almost universally report decreased patency of stents with higher rates of recurrent obstruction and need for re-intervention [46 •• , 49, 50, 53].…”

Section: Emerging Technologiesmentioning

confidence: 99%

Surgical and Endoscopic Options for Benign and Malignant Gastric Outlet Obstruction

Miller

Schwaitzberg

2014

Curr Surg Rep

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Gastric outlet obstruction (GOO) can be due to a variety of causes of both benign and malignant sources. As the etiology of GOO shifts from mostly benign to mostly malignant, treatment options have also evolved. Traditional options have only included surgery, but an increase in technology has seen the emergence of endoscopic alternatives. For benign disease, such as peptic ulcer disease, endoscopic balloon dilation has reduced the number of patients needing to undergo larger and more invasive surgical procedures. It has also proven successful in treating obstruction from stricture following bariatric surgery, but surgical revision or reversal remains the gold standard. Numerous surgical procedures have shown effectiveness when treating GOO, with new procedures constantly emerging. When malignancy is the cause, the procedural focus shifts from curative to palliative with the main focus being resumption of oral intake. Endoscopic stenting provides a viable alternative to gastro-jejunostomy, but due to problems with re-obstruction and stent migration, it should be reserved for patients with shorter life expectancies.

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Enteral stenting versus gastrojejunostomy for palliation of malignant gastric outlet obstruction

Abstract: ES is associated with fewer complications, shorter LOHS, but higher reintervention rates and overall charges.

Cited by 144 publications

References 29 publications

Lumen apposing metal stents: A review of current uses and outcomes

Lumen apposing metal stents: A review of current uses and outcomes

Malignus gastroduodenalis obstrukció endoszkópos palliációja fedetlen enteralis stenttel

Surgical and Endoscopic Options for Benign and Malignant Gastric Outlet Obstruction

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