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CC BY 4.0 · Endosc Int Open 2025; 13: a25399270
DOI: 10.1055/a-2539-9270
Original article

Efficacy of a higher-flexibility duodenal stent for palliation of gastric outlet obstruction

Noa Eveline Adriana Kapteijn
1   Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands (Ringgold ID: RIN6993)
,
Pauline A. Zellenrath
1   Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands (Ringgold ID: RIN6993)
,
Peter Siersema
1   Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands (Ringgold ID: RIN6993)
,
Agnes N Reijm
1   Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands (Ringgold ID: RIN6993)
,
Lydi Van Driel
2   Gastroenterology and Hepatology, Reinier de Graaf Gasthuis, Rotterdam, Netherlands (Ringgold ID: RIN84744)
1   Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands (Ringgold ID: RIN6993)
,
Pieter J.F. de Jonge
1   Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands (Ringgold ID: RIN6993)
,
Wim J. Lammers
1   Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands (Ringgold ID: RIN6993)
,
Judith Honing
1   Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands (Ringgold ID: RIN6993)
,
Manon C.W. Spaander
1   Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands (Ringgold ID: RIN6993)
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Abstract

Background and study aims

Duodenal self-expandable metallic stent (SEMS) placement is a common palliative treatment for malignant gastric outlet obstruction symptoms (GOOS). The higher flexibility of the WallFlex Duodenal Soft stent aims to ease stent placement and reduce adverse events (AE). This descriptive study compared the WallFlex Soft stent with other duodenal SEMS designs with regard to efficacy and safety.

Patients and methods

Patients receiving the WallFlex Duodenal Soft stent as first-line treatment for GOOS were included in a prospective cohort (2019–2023). A retrospective cohort (1998–2019) with patients treated with other duodenal SEMS designs as first-line treatment for GOOS was used for comparison.

Results

In the prospective cohort, 11 patients were treated with the WallFlex Duodenal Soft, achieving 100% technical and 82% clinical success rates. The retrospective cohort of 147 patients with various types of duodenal SEMS showed 97% technical and 86% clinical success. For the WallFlex Duodenal Soft vs. the other duodenal SEMS, the overall survival was 101 vs. 82 days and median symptom-free survival was 83 vs. 28 days. AE rates were 18% vs. 28%, respectively.

Conclusions

The WallFlex Duodenal Soft stent effectively treats GOOS in palliative patients and seems to be associated with longer symptom-free survival and lower AE rates compared with previous duodenal SEMS designs.

Keywords

Endoscopy Upper GI Tract - Reflux disease - Malignant strictures - Dilation, injection, stenting - Quality and logistical aspects - Performance and complications

Supplementary Material



Publikationsverlauf

Eingereicht: 24. September 2024

Angenommen nach Revision: 11. Februar 2025

Accepted Manuscript online:
14. Februar 2025

Artikel online veröffentlicht:
14. März 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Noa Eveline Adriana Kapteijn, Pauline A. Zellenrath, Peter Siersema, Agnes N Reijm, Lydi Van Driel, Pieter J.F. de Jonge, Wim J. Lammers, Judith Honing, Manon C.W. Spaander. Efficacy of a higher-flexibility duodenal stent for palliation of gastric outlet obstruction. Endosc Int Open 2025; 13: a25399270.
DOI: 10.1055/a-2539-9270
 

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