Palliative stenting for late malignant gastric outlet obstruction

James M. Kiely, Kulwinder S. Dua, Shannon J. Graewin, Attila Nakeeb, Beth A. Erickson, Paul S. Ritch, Stuart D. Wilson, Henry A. Pitt

Research output: Contribution to journalArticle

Abstract

Malignant gastric outlet obstruction (MGO) is a late complication of pancreatobiliary and gastric cancers. Although surgical gastrojejunostomy provides good palliation, many of these patients may be nonoperative candidates or underwent previous extensive resection such as a Whipple procedure. Recently, endoscopically placed self-expanding metallic stents (SEMS) have been used to palliate MGO. The aim of this study was to evaluate the efficacy of SEMS for palliation of late MGO. Medical records of patients with endoscopic placement of SEMS for palliation of MGO were reviewed. Results showed that 30 patients with MGO had SEMS placed for late gastroduodenal (n∈=∈20) or jejunal (n∈=∈10) obstruction. Twenty-one patients (70%) had previous surgery. Return to oral feeding was observed in 90% of patients who presented with recurrent obstruction after prior bypass surgery and in 88% of nonoperative patients in whom SEMS were placed as the primary therapy for obstruction. No major complications were observed, and median survival after SEMS was 4.1 months (0.1 to 10.5 months). SEMS also did not interfere with biliary drainage. In conclusion, endoscopically placed SEMS are safe and provide good palliation for late malignant gastroduodenal and jejunal strictures and are an excellent complement to recurrent obstruction after surgical gastrojejunostomy.

Original languageEnglish (US)
Pages (from-to)107-113
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume11
Issue number1
DOIs
StatePublished - Jan 2007
Externally publishedYes

Fingerprint

Gastric Outlet Obstruction
Stents
Gastric Bypass
Stomach Neoplasms
Medical Records
Drainage
Pathologic Constriction
Survival

Keywords

  • Endoscopic stents
  • Enteral metal stents
  • Gastric outlet obstruction

ASJC Scopus subject areas

  • Surgery

Cite this

Kiely, J. M., Dua, K. S., Graewin, S. J., Nakeeb, A., Erickson, B. A., Ritch, P. S., ... Pitt, H. A. (2007). Palliative stenting for late malignant gastric outlet obstruction. Journal of Gastrointestinal Surgery, 11(1), 107-113. https://doi.org/10.1007/s11605-006-0060-4

Palliative stenting for late malignant gastric outlet obstruction. / Kiely, James M.; Dua, Kulwinder S.; Graewin, Shannon J.; Nakeeb, Attila; Erickson, Beth A.; Ritch, Paul S.; Wilson, Stuart D.; Pitt, Henry A.

In: Journal of Gastrointestinal Surgery, Vol. 11, No. 1, 01.2007, p. 107-113.

Research output: Contribution to journalArticle

Kiely, JM, Dua, KS, Graewin, SJ, Nakeeb, A, Erickson, BA, Ritch, PS, Wilson, SD & Pitt, HA 2007, 'Palliative stenting for late malignant gastric outlet obstruction', Journal of Gastrointestinal Surgery, vol. 11, no. 1, pp. 107-113. https://doi.org/10.1007/s11605-006-0060-4
Kiely JM, Dua KS, Graewin SJ, Nakeeb A, Erickson BA, Ritch PS et al. Palliative stenting for late malignant gastric outlet obstruction. Journal of Gastrointestinal Surgery. 2007 Jan;11(1):107-113. https://doi.org/10.1007/s11605-006-0060-4
Kiely, James M. ; Dua, Kulwinder S. ; Graewin, Shannon J. ; Nakeeb, Attila ; Erickson, Beth A. ; Ritch, Paul S. ; Wilson, Stuart D. ; Pitt, Henry A. / Palliative stenting for late malignant gastric outlet obstruction. In: Journal of Gastrointestinal Surgery. 2007 ; Vol. 11, No. 1. pp. 107-113.
@article{637d49b355fa45799a9e1ffa940c2fd9,
title = "Palliative stenting for late malignant gastric outlet obstruction",
abstract = "Malignant gastric outlet obstruction (MGO) is a late complication of pancreatobiliary and gastric cancers. Although surgical gastrojejunostomy provides good palliation, many of these patients may be nonoperative candidates or underwent previous extensive resection such as a Whipple procedure. Recently, endoscopically placed self-expanding metallic stents (SEMS) have been used to palliate MGO. The aim of this study was to evaluate the efficacy of SEMS for palliation of late MGO. Medical records of patients with endoscopic placement of SEMS for palliation of MGO were reviewed. Results showed that 30 patients with MGO had SEMS placed for late gastroduodenal (n∈=∈20) or jejunal (n∈=∈10) obstruction. Twenty-one patients (70{\%}) had previous surgery. Return to oral feeding was observed in 90{\%} of patients who presented with recurrent obstruction after prior bypass surgery and in 88{\%} of nonoperative patients in whom SEMS were placed as the primary therapy for obstruction. No major complications were observed, and median survival after SEMS was 4.1 months (0.1 to 10.5 months). SEMS also did not interfere with biliary drainage. In conclusion, endoscopically placed SEMS are safe and provide good palliation for late malignant gastroduodenal and jejunal strictures and are an excellent complement to recurrent obstruction after surgical gastrojejunostomy.",
keywords = "Endoscopic stents, Enteral metal stents, Gastric outlet obstruction",
author = "Kiely, {James M.} and Dua, {Kulwinder S.} and Graewin, {Shannon J.} and Attila Nakeeb and Erickson, {Beth A.} and Ritch, {Paul S.} and Wilson, {Stuart D.} and Pitt, {Henry A.}",
year = "2007",
month = "1",
doi = "10.1007/s11605-006-0060-4",
language = "English (US)",
volume = "11",
pages = "107--113",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",
number = "1",

}

TY - JOUR

T1 - Palliative stenting for late malignant gastric outlet obstruction

AU - Kiely, James M.

AU - Dua, Kulwinder S.

AU - Graewin, Shannon J.

AU - Nakeeb, Attila

AU - Erickson, Beth A.

AU - Ritch, Paul S.

AU - Wilson, Stuart D.

AU - Pitt, Henry A.

PY - 2007/1

Y1 - 2007/1

N2 - Malignant gastric outlet obstruction (MGO) is a late complication of pancreatobiliary and gastric cancers. Although surgical gastrojejunostomy provides good palliation, many of these patients may be nonoperative candidates or underwent previous extensive resection such as a Whipple procedure. Recently, endoscopically placed self-expanding metallic stents (SEMS) have been used to palliate MGO. The aim of this study was to evaluate the efficacy of SEMS for palliation of late MGO. Medical records of patients with endoscopic placement of SEMS for palliation of MGO were reviewed. Results showed that 30 patients with MGO had SEMS placed for late gastroduodenal (n∈=∈20) or jejunal (n∈=∈10) obstruction. Twenty-one patients (70%) had previous surgery. Return to oral feeding was observed in 90% of patients who presented with recurrent obstruction after prior bypass surgery and in 88% of nonoperative patients in whom SEMS were placed as the primary therapy for obstruction. No major complications were observed, and median survival after SEMS was 4.1 months (0.1 to 10.5 months). SEMS also did not interfere with biliary drainage. In conclusion, endoscopically placed SEMS are safe and provide good palliation for late malignant gastroduodenal and jejunal strictures and are an excellent complement to recurrent obstruction after surgical gastrojejunostomy.

AB - Malignant gastric outlet obstruction (MGO) is a late complication of pancreatobiliary and gastric cancers. Although surgical gastrojejunostomy provides good palliation, many of these patients may be nonoperative candidates or underwent previous extensive resection such as a Whipple procedure. Recently, endoscopically placed self-expanding metallic stents (SEMS) have been used to palliate MGO. The aim of this study was to evaluate the efficacy of SEMS for palliation of late MGO. Medical records of patients with endoscopic placement of SEMS for palliation of MGO were reviewed. Results showed that 30 patients with MGO had SEMS placed for late gastroduodenal (n∈=∈20) or jejunal (n∈=∈10) obstruction. Twenty-one patients (70%) had previous surgery. Return to oral feeding was observed in 90% of patients who presented with recurrent obstruction after prior bypass surgery and in 88% of nonoperative patients in whom SEMS were placed as the primary therapy for obstruction. No major complications were observed, and median survival after SEMS was 4.1 months (0.1 to 10.5 months). SEMS also did not interfere with biliary drainage. In conclusion, endoscopically placed SEMS are safe and provide good palliation for late malignant gastroduodenal and jejunal strictures and are an excellent complement to recurrent obstruction after surgical gastrojejunostomy.

KW - Endoscopic stents

KW - Enteral metal stents

KW - Gastric outlet obstruction

UR - http://www.scopus.com/inward/record.url?scp=34250204156&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34250204156&partnerID=8YFLogxK

U2 - 10.1007/s11605-006-0060-4

DO - 10.1007/s11605-006-0060-4

M3 - Article

C2 - 17390196

AN - SCOPUS:34250204156

VL - 11

SP - 107

EP - 113

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

IS - 1

ER -