Covered stent placement in patients with recurrent cancer after a Billroth I reconstruction

To assess the technical feasibility and clinical effectiveness of covered stent placement in patients with recurrent malignant obstructions after Billroth I reconstruction.

From June 1997 to November 2005, 16 patients underwent covered stent placement for recurrent gastric cancer after Billroth I reconstruction. A total of 19 covered stents were used, including 14 dual stents and five fully covered stents, as available.

Stent placement was technically successful in all patients, with 13 of 16 patients (81%) showing improvement of symptoms. Stent migration occurred in one patient, tumor ingrowth in one, and stent collapse and/or bowel perforation in one. Nine patients (56%) had concomitant (n=7) or subsequent (n=2) biliary obstruction. One patient was lost to follow-up. The remaining 15 patients died 5-628 days (median, 52 days; mean, 120 days) after stent placement due to progression of disease or pneumonia.

Placement of covered metallic stents is feasible and effective in patients with recurrent malignant obstruction after Billroth I reconstruction.