Endoscopic treatment of malignant gastric and duodenal strictures: A prospective, multicenter study

Andrea Tringali, Paul Didden, Alessandro Repici, Manon Spaander, Michael J. Bourke, Stephen J. Williams, Julius Spicak, Pavel Drastich, Massimiliano Mutignani, Vincenzo Perri, André Roy, Krystal Johnston, Guido Costamagna

Research output: Contribution to journalArticle

Abstract

Background Malignant gastric outlet obstruction is often treated by stent placement. Objective To investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms. Design Prospective, observational, multicenter registry. Setting Six tertiary care centers in 5 countries. Patients A total of 108 adult patients with malignant gastric outlet obstruction. Interventions Placement of an uncovered, self-expandable, metal duodenal stent. Main Outcome Measurements The primary endpoint was stent patency at 14 days after stent implantation. Secondary endpoints included stent patency at 1, 2, 3, and 6 months, gastric outlet obstruction scoring system (GOOSS) scores at 14 days and 1, 2, 3, and 6 months after stent deployment, technical success, adverse events, and patient survival (ie, confirmed duration of the implant). Results Technical success was achieved in 99.1% of stent placements. Stent patency at 14 days was 94.6%. Kaplan-Meier estimates of stent patency were 92.9% at 1 month, 86.2% at 2 months, 81.9% at 3 months, and 63.4% at 6 months. At 14 days, GOOSS scores increased by a median of 1 point. The overall GI adverse event rate was 32.4%; however, the stent-related adverse event rate was 19.4%. The median implant duration was 47 days (range 0-195 days). Limitations Observational study, no control group. Conclusions Duodenal stent placement resulted in prompt relief of malignant gastric outlet obstruction and improved GOOSS scores. (Clinical trial registration number: NCT00991614.).

Original languageEnglish
Pages (from-to)66-75
Number of pages10
JournalGastrointestinal Endoscopy
Volume79
Issue number1
DOIs
Publication statusPublished - Jan 2014

    Fingerprint

Keywords

  • gastric outlet obstruction scoring system
  • gastrojejunostomy
  • GJJ
  • GOOSS

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

Tringali, A., Didden, P., Repici, A., Spaander, M., Bourke, M. J., Williams, S. J., Spicak, J., Drastich, P., Mutignani, M., Perri, V., Roy, A., Johnston, K., & Costamagna, G. (2014). Endoscopic treatment of malignant gastric and duodenal strictures: A prospective, multicenter study. Gastrointestinal Endoscopy, 79(1), 66-75. https://doi.org/10.1016/j.gie.2013.06.032