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Metallic stents in the treatment of duodenal obstruction: technical issues and results
1Department of Medical Imaging, Mount Sinai Hospital, Toronto, Ont.
Objective:
To evaluate the efficacy of duodenal stenting procedures and to review technical issues with these procedures in a series of cases over a 1-year period.
Methods:
Expandable metallic stents (Wallstents) of varying sizes were introduced and deployed in 4 patients (1 man and 3 women 42 to 81 years of age). Each patient underwent a separate method of stent introduction with either fluoroscopic or endoscopic guidance, either perorally, transgastrically and transhepatically.
Results:
All procedures were technically successful, allowing patients to continue eating normally. In 1 patient, stent foreshortening necessitated the introduction of a second stent. Another patient experienced transient stent obstruction by food; this resolved spontaneously and required no additional intervention. Based on the patients' continuing ability to tolerate food, it was believed that the stents remained patent until the time of death (from 3 days to 9 weeks with a mean of 5.25 weeks).
Conclusions:
Duodenal stenting procedures provide a relatively new, technically feasible and efficacious method of managing duodenal obstructions, especially in patients who are poor candidates for surgery.