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Incidence and factors associated with stent dysfunction and pancreatitis after gastroduodenal stenting for malignant
Daiki Yamashige1, Susumu Hijioka1, Yoshikuni Nagashio1
1Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital Japan, Chuo-ku, Japan.
Endoscopy International Open
|March 11, 2024
Summary
This study found that Niti-S stent deployment significantly reduced stent dysfunction in malignant gastric outlet obstruction (mGOO) patients. Main pancreatic duct caliber less than 3 mm independently predicted pancreatitis, guiding better stent selection for mGOO.
Area of Science:
- Gastroenterology
- Endoscopic procedures
- Oncology
Background:
- Endoscopic gastroduodenal stent (GDS) deployment is standard for malignant gastric outlet obstruction (mGOO).
- Stent dysfunction (SD) and pancreatitis are common complications.
- Investigating factors influencing SD and pancreatitis is crucial for optimizing patient outcomes.
Purpose of the Study:
- To determine the incidence of stent dysfunction (SD) and pancreatitis after GDS deployment for mGOO.
- To identify factors contributing to SD and pancreatitis.
- To evaluate the impact of stent type and patient factors on outcomes.
Main Methods:
- Retrospective review of 203 patients undergoing GDS for mGOO.
- Analysis of stent dysfunction (tumor ingrowth, kinking, migration) and pancreatitis incidence.
- Multivariate analysis to identify significant predictors of SD and pancreatitis.
Main Results:
- Stent dysfunction occurred in 33.5% of patients; cumulative incidence reached 41.1%.
- Niti-S stent deployment was associated with significantly reduced SD (sHR 0.26, P=0.01).
- Main pancreatic duct caliber < 3 mm independently predicted pancreatitis (OR 6.8, P=0.03).
Conclusions:
- Niti-S pyloric/duodenal stent deployment significantly lowers SD incidence in mGOO.
- Stent selection, patient life expectancy, and main pancreatic duct caliber are key considerations for GDS placement.
- Optimizing GDS strategy can improve outcomes for mGOO patients.
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