Palliation of malignant gastric outlet obstruction with self-expanding metal stents

Self-expanding metal stents have long been used in the management of patients with malignant esophageal and malignant biliary obstruction. The aim of the present study was to report on the palliation of malignant gastric outlet obstruction using self-expanding endoprostheses.

Between March 1993 and December 1994, 12 patients (eight women, four men, mean age 64 years) suffering from malignant gastric outlet obstruction due to recurrent gastric carcinoma (seven patients) and pancreatic head carcinoma (five patients) presented with an inability to eat and intractable vomiting. The patients were managed with peroral insertion of self-expanding metal stents.

Peroral introduction of the stent with the aid of a stabilizing overtube was successful in all patients, with the stent being supported as it was being advanced through the stenosis. Proper release of the stent into the stenotic area was achieved in all cases, relieving the intractable vomiting. The procedure was accomplished without any complications. All patients were able to eat semisolid food four days after the stent insertion. Apart from an asymptomatic partial stent occlusion in one patient, no other complications were seen during the short-term follow-up one, two, and three months after discharge.

These preliminary results suggest that self-expanding stents can effectively relieve malignant gastric outlet obstruction.