Treatment of malignant gastric outlet obstruction with metallic stents

Assessment of whether gastrointestinal position alters efficacy

Hao Tsai Cheng, Ching Song Lee, Cheng Hui Lin, Chi Liang Cheng, Jui-Hsiang Tang, Yung Kuan Tsou, Jui Min Chang, Mu Hsien Lee, Kai Feng Sung, Nai Jen Liu

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: Gastric outlet obstruction (GOO) is a late complication of advanced gastric, pancreatic, and duodenal cancer. Palliative treatment of the obstruction is the main aim of therapy for these patients. Selfexpandable metal stents are used for treating GOO. From our experience, the placement of the stent across the pylorus is easier and makes the curve of stent better than when the stent is placed within the duodenal area. The purposes of this study were to assess the efficacy of stents placed in either the duodenal area or across the pyloric valve in relieving GOO symptoms and to evaluatewhether the location of the stent affects treatment outcomes. Materials and Methods: This was a retrospective single-site study of 44 patients with malignant GOO. Expanding metal stents were placed either across the pyloric valve (n = 22; group A) or in the duodenum area (n = 22; group B). Improvement in oral intake was monitored using the Gastric Outlet Obstruction Scoring System (GOOSS). The end of the studywas death of the last enrolled patient or 6 months after enrollment of the last patient, or whatever came first. Results: Stent implantation similarly improved the patients' tolerance for food intake from baseline for both groups A and B (median [interquartile range]; 2 [2-3] and 2 [2-3], respectively). Patients in group B who received adjunctive chemotherapy had greater improvement in GOOSS and survival than patients in group B who did not have chemotherapy or any group A patients (P < 0.05). Stent patency was not affected by stent position or chemotherapy. Conclusion: Palliative treatment of GOO with placement of an expandable metal stent improved the tolerability of food intake. The location of stent across the pyloric valve or within the duodenum did not affect the efficacy of the procedure or stent patency.

Original languageEnglish
Pages (from-to)1027-1032
Number of pages6
JournalJournal of Investigative Medicine
Volume60
Issue number7
DOIs
Publication statusPublished - Jan 1 2012
Externally publishedYes

Fingerprint

Gastric Outlet Obstruction
Stents
Chemotherapy
Therapeutics
Metals
Palliative Care
Duodenum
Drug Therapy
Eating
Duodenal Neoplasms
Pylorus
Pancreatic Neoplasms

Keywords

  • Duodenal obstruction
  • Malignant gastric outlet obstruction
  • Pylorus ring
  • Self-expanding metallic stents

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Treatment of malignant gastric outlet obstruction with metallic stents : Assessment of whether gastrointestinal position alters efficacy. / Cheng, Hao Tsai; Lee, Ching Song; Lin, Cheng Hui; Cheng, Chi Liang; Tang, Jui-Hsiang; Tsou, Yung Kuan; Chang, Jui Min; Lee, Mu Hsien; Sung, Kai Feng; Liu, Nai Jen.

In: Journal of Investigative Medicine, Vol. 60, No. 7, 01.01.2012, p. 1027-1032.

Research output: Contribution to journalArticle

Cheng, Hao Tsai ; Lee, Ching Song ; Lin, Cheng Hui ; Cheng, Chi Liang ; Tang, Jui-Hsiang ; Tsou, Yung Kuan ; Chang, Jui Min ; Lee, Mu Hsien ; Sung, Kai Feng ; Liu, Nai Jen. / Treatment of malignant gastric outlet obstruction with metallic stents : Assessment of whether gastrointestinal position alters efficacy. In: Journal of Investigative Medicine. 2012 ; Vol. 60, No. 7. pp. 1027-1032.
@article{eb45b24031fa409b9843bc25d366e943,
title = "Treatment of malignant gastric outlet obstruction with metallic stents: Assessment of whether gastrointestinal position alters efficacy",
abstract = "Objectives: Gastric outlet obstruction (GOO) is a late complication of advanced gastric, pancreatic, and duodenal cancer. Palliative treatment of the obstruction is the main aim of therapy for these patients. Selfexpandable metal stents are used for treating GOO. From our experience, the placement of the stent across the pylorus is easier and makes the curve of stent better than when the stent is placed within the duodenal area. The purposes of this study were to assess the efficacy of stents placed in either the duodenal area or across the pyloric valve in relieving GOO symptoms and to evaluatewhether the location of the stent affects treatment outcomes. Materials and Methods: This was a retrospective single-site study of 44 patients with malignant GOO. Expanding metal stents were placed either across the pyloric valve (n = 22; group A) or in the duodenum area (n = 22; group B). Improvement in oral intake was monitored using the Gastric Outlet Obstruction Scoring System (GOOSS). The end of the studywas death of the last enrolled patient or 6 months after enrollment of the last patient, or whatever came first. Results: Stent implantation similarly improved the patients' tolerance for food intake from baseline for both groups A and B (median [interquartile range]; 2 [2-3] and 2 [2-3], respectively). Patients in group B who received adjunctive chemotherapy had greater improvement in GOOSS and survival than patients in group B who did not have chemotherapy or any group A patients (P < 0.05). Stent patency was not affected by stent position or chemotherapy. Conclusion: Palliative treatment of GOO with placement of an expandable metal stent improved the tolerability of food intake. The location of stent across the pyloric valve or within the duodenum did not affect the efficacy of the procedure or stent patency.",
keywords = "Duodenal obstruction, Malignant gastric outlet obstruction, Pylorus ring, Self-expanding metallic stents",
author = "Cheng, {Hao Tsai} and Lee, {Ching Song} and Lin, {Cheng Hui} and Cheng, {Chi Liang} and Jui-Hsiang Tang and Tsou, {Yung Kuan} and Chang, {Jui Min} and Lee, {Mu Hsien} and Sung, {Kai Feng} and Liu, {Nai Jen}",
year = "2012",
month = "1",
day = "1",
doi = "10.2310/JIM.0b013e31826509c8",
language = "English",
volume = "60",
pages = "1027--1032",
journal = "Journal of Investigative Medicine",
issn = "1081-5589",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Treatment of malignant gastric outlet obstruction with metallic stents

T2 - Assessment of whether gastrointestinal position alters efficacy

AU - Cheng, Hao Tsai

AU - Lee, Ching Song

AU - Lin, Cheng Hui

AU - Cheng, Chi Liang

AU - Tang, Jui-Hsiang

AU - Tsou, Yung Kuan

AU - Chang, Jui Min

AU - Lee, Mu Hsien

AU - Sung, Kai Feng

AU - Liu, Nai Jen

PY - 2012/1/1

Y1 - 2012/1/1

N2 - Objectives: Gastric outlet obstruction (GOO) is a late complication of advanced gastric, pancreatic, and duodenal cancer. Palliative treatment of the obstruction is the main aim of therapy for these patients. Selfexpandable metal stents are used for treating GOO. From our experience, the placement of the stent across the pylorus is easier and makes the curve of stent better than when the stent is placed within the duodenal area. The purposes of this study were to assess the efficacy of stents placed in either the duodenal area or across the pyloric valve in relieving GOO symptoms and to evaluatewhether the location of the stent affects treatment outcomes. Materials and Methods: This was a retrospective single-site study of 44 patients with malignant GOO. Expanding metal stents were placed either across the pyloric valve (n = 22; group A) or in the duodenum area (n = 22; group B). Improvement in oral intake was monitored using the Gastric Outlet Obstruction Scoring System (GOOSS). The end of the studywas death of the last enrolled patient or 6 months after enrollment of the last patient, or whatever came first. Results: Stent implantation similarly improved the patients' tolerance for food intake from baseline for both groups A and B (median [interquartile range]; 2 [2-3] and 2 [2-3], respectively). Patients in group B who received adjunctive chemotherapy had greater improvement in GOOSS and survival than patients in group B who did not have chemotherapy or any group A patients (P < 0.05). Stent patency was not affected by stent position or chemotherapy. Conclusion: Palliative treatment of GOO with placement of an expandable metal stent improved the tolerability of food intake. The location of stent across the pyloric valve or within the duodenum did not affect the efficacy of the procedure or stent patency.

AB - Objectives: Gastric outlet obstruction (GOO) is a late complication of advanced gastric, pancreatic, and duodenal cancer. Palliative treatment of the obstruction is the main aim of therapy for these patients. Selfexpandable metal stents are used for treating GOO. From our experience, the placement of the stent across the pylorus is easier and makes the curve of stent better than when the stent is placed within the duodenal area. The purposes of this study were to assess the efficacy of stents placed in either the duodenal area or across the pyloric valve in relieving GOO symptoms and to evaluatewhether the location of the stent affects treatment outcomes. Materials and Methods: This was a retrospective single-site study of 44 patients with malignant GOO. Expanding metal stents were placed either across the pyloric valve (n = 22; group A) or in the duodenum area (n = 22; group B). Improvement in oral intake was monitored using the Gastric Outlet Obstruction Scoring System (GOOSS). The end of the studywas death of the last enrolled patient or 6 months after enrollment of the last patient, or whatever came first. Results: Stent implantation similarly improved the patients' tolerance for food intake from baseline for both groups A and B (median [interquartile range]; 2 [2-3] and 2 [2-3], respectively). Patients in group B who received adjunctive chemotherapy had greater improvement in GOOSS and survival than patients in group B who did not have chemotherapy or any group A patients (P < 0.05). Stent patency was not affected by stent position or chemotherapy. Conclusion: Palliative treatment of GOO with placement of an expandable metal stent improved the tolerability of food intake. The location of stent across the pyloric valve or within the duodenum did not affect the efficacy of the procedure or stent patency.

KW - Duodenal obstruction

KW - Malignant gastric outlet obstruction

KW - Pylorus ring

KW - Self-expanding metallic stents

UR - http://www.scopus.com/inward/record.url?scp=85006117583&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85006117583&partnerID=8YFLogxK

U2 - 10.2310/JIM.0b013e31826509c8

DO - 10.2310/JIM.0b013e31826509c8

M3 - Article

VL - 60

SP - 1027

EP - 1032

JO - Journal of Investigative Medicine

JF - Journal of Investigative Medicine

SN - 1081-5589

IS - 7

ER -