Endoscopy 2020; 52(S 01): S245
DOI: 10.1055/s-0040-1704768
ESGE Days 2020 ePoster Podium presentations
Saturday, April 25, 2020 15:30 – 16:00 Upper GI: Stenting and variceal ePoster Podium 8ligation and surveillance
© Georg Thieme Verlag KG Stuttgart · New York

CLINICAL OUTCOMES OF PALLIATIVE GASTRODUODENAL AND JEJUNAL STENTING IN PATIENTS WITH ADVANCED CANCER: RESULTS OF A TWO-CENTER RETROSPECTIVE STUDY

S Davydova
1   Peoples’ Friendship University of Russia (RUDN University), Institute of Medicine, Department of Faculty Surgery, Moscow, Russian Federation
,
A Fedorov
1   Peoples’ Friendship University of Russia (RUDN University), Institute of Medicine, Department of Faculty Surgery, Moscow, Russian Federation
,
O Yun
2   University Clinical Hospital #1, Endoscopy Department, Moscow, Russian Federation
,
A Klimov
1   Peoples’ Friendship University of Russia (RUDN University), Institute of Medicine, Department of Faculty Surgery, Moscow, Russian Federation
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Palliative self-expandable metal stent [SEMS] placement for malignant gastroenteral stenosis can be challenging in advanced cancer, especially in cases of total gastric involvement and combined duodenal and biliary obstruction. The study was aimed to evaluate early and long-term outcomes of gastroenteral stenting.

Methods 75 patients (median age – 72 years) presenting with gastroenteral obstruction at the period of 2004–2018 in a university surgical center and city oncological hospital were included in a retrospective study. Patients were unfit for surgery due to advanced primary, recurrent or metastatic gastric (57), pancreatobiliary (16) or other (2) cancer with the stenosis at the level of stomach (gastric outlet – 42, multi-level obstruction – 7), duodenum (17), jejunum (3), and gastroenteral anastomosis (6). Adverse events and survival were analyzed.

Results 88 SEMS (uncovered – 67, covered – 21) were implanted. Technical and functional success was achieved in 74 patients (98,7%). In 13 patients gastroduodenal stenting was combined with biliary. Early complications were observed in 5 cases (6,7%): proximal migration of partially covered SEMS 3–5 days after their placement in the gastric outlet (2), obstructive jaundice (2), and bleeding (1). Jaundice occurred within 6 days after gastroduodenal uncovered SEMS placement in 2 patients with advanced gastric cancer without previous history of bile duct dilation and in 1 case was associated with acute cholangitis. 3 patients died within 11 days after the procedure, in-hospital mortality – 4%. Long-term complications included recurrence of obstructive symptoms (8) due to stent dysfunction 2–8 months after stenting. Median survival was 101 days.

Conclusions SEMS placement is an effective palliation for patients with malignant gastroenteral obstruction, which in cases of total gastric cancer or after previous gastrectomy may be the only option to restore oral intake. Significant early complications include obstructive jaundice and cholangitis. Covered stents are associated with an increased risk of migration.