Pyloric Stent Insertion in Malignant Gastric Outlet Obstruction (MGGO): Moving Beyond Palliation

Aims MGOO is seen in advance malignancies. Surgical gastro-jeujenostomy is standard palliative treatment and upfront surgery in resectable gastric cancers. Importance of relieving obstruction in resectable gastric tumours is to have uninterrupted neoadjuvant chemotherapy, which improves overall survival. Our aim is to evaluate efficacy and safety of pyloric stents in gastric outlet obstruction in gastric cancer and to evaluate 1-year survival in patients with resectable obstructing gastric tumours where stents were placed as a bridge to surgery.

Methods A retrospective review of 161 patients, meeting the inclusion and exclusion criteria and underwent endoscopic placement of self expandable metallic stent (SEMS) for GOO due to gastric cancer. Data was collected for the duration of 5 years from January, 2014 to March, 2019.

Results Stent efficacy was measured using gastric outlet obstruction scoring system (GOOSS) at the time of stent insertion, after 1 and 12 weeks. GOOSS improved at 1 week as well as at 12 weeks post stenting, when compared to baseline. P value was also statistically significant. The serum albumin level and BMI, had comparable results before and after stenting. 35/161 patients underwent neo-adjuvant chemotherapy followed by curative surgery. On year survival rate following curative surgery in there patient was 87.5 %. No serious stent related complication were seen, however non serious complication rate was 41 %, including stent migration. No additional post surgery complications were seen in pre surgery stented patient in our study on comparison to literature.

Conclusions SEMS insertion in MGOO helps maintain nutritional status during neo-adjuvant period, improves survival and is not associated with an increased risk of post-operative complications. Therefore, it should be used as a palliative measure but also as a bridging therapy for patients with obstructing resectable gastric tumours.

Citation: Saeed SM, Bilal S, Siddique MZ et al. eP151 PYLORIC STENT INSERTION IN MALIGNANT GASTRIC OUTLET OBSTRUCTION (MGGO): MOVING BEYOND PALLIATION. Endoscopy 2021; 53: S146.

Publikationsverlauf

Artikel online veröffentlicht:
19. März 2021