Feasibility of Self-Expandable Metal Stent Placement with Side-Viewing Endoscope for Malignant Distal Duodenal Obstruction

Jin Myung Park, Byung Hoon Min, Sang Hyub Lee, Kwang Hyun Chung, Jae Min Lee, Byeong Jun Song, Jun Kyu Lee, Ji Kon Ryu, Young-Tae Kim

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background and Aim: Self-expandable metal stents (SEMSs) have been a good treatment option for malignant intestinal obstruction. However, stent placement with a gastroscope can be technically difficult for the distal duodenum obstruction. A side-viewing duodenoscope may be helpful for these patients. We report our experiences in the insertion of SEMSs to distal duodenum with a side-viewing endoscope.

Methods: We retrospectively analyzed our database of SEMS placement for malignant distal duodenum obstruction between April 2006 and April 2013. All patients underwent SEMS placement using the side-viewing endoscope (duodenoscope). Main outcomes are technical success, clinical success, complication rates, stent patency, and overall survival. In addition, database from other tertiary center was analyzed, where SEMS insertion was performed with forward-viewing endoscopes (gastroscope or colonoscope). Success and complication rates were compared with ours.

Results: A total of 31 patients were reviewed. Pancreatic cancer was the most common cause (87.1 %). Technical and clinical success was achieved in all cases. Procedure-related complication occurred in one patient, who experienced micro-perforation of the duodenum. The patient improved with conservative treatment. Median duration of stent patency was 125 days (95 % CI 75–175), and median overall survival was 134 days (95 % CI 77–191). Biliary obstruction was present in 12.9 % of patients, who underwent biliary stent placement at the same time without changing endoscopes. In forward-viewing endoscopes group, 15 cases were included. Technical and clinical success was achieved in all cases, and no procedure-related complication occurred.

Conclusions: The insertion of SEMSs to distal duodenum with a duodenoscope could be performed effectively and safely in patients with malignant obstruction.

Original languageEnglish
Pages (from-to)524-530
Number of pages7
JournalDigestive Diseases and Sciences
Volume60
Issue number2
DOIs
StatePublished - 1 Jan 2015

Fingerprint

Duodenal Obstruction
Endoscopes
Duodenum
Duodenoscopes
Stents
Gastroscopes
Colonoscopes
Databases
Survival
Intestinal Obstruction
Self Expandable Metallic Stents
Pancreatic Neoplasms

Keywords

  • Duodenal obstruction
  • Duodenoscopes
  • Gastrointestinal neoplasms
  • Stents

Cite this

Park, Jin Myung ; Min, Byung Hoon ; Lee, Sang Hyub ; Chung, Kwang Hyun ; Lee, Jae Min ; Song, Byeong Jun ; Lee, Jun Kyu ; Ryu, Ji Kon ; Kim, Young-Tae. / Feasibility of Self-Expandable Metal Stent Placement with Side-Viewing Endoscope for Malignant Distal Duodenal Obstruction. In: Digestive Diseases and Sciences. 2015 ; Vol. 60, No. 2. pp. 524-530.
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title = "Feasibility of Self-Expandable Metal Stent Placement with Side-Viewing Endoscope for Malignant Distal Duodenal Obstruction",
abstract = "Background and Aim: Self-expandable metal stents (SEMSs) have been a good treatment option for malignant intestinal obstruction. However, stent placement with a gastroscope can be technically difficult for the distal duodenum obstruction. A side-viewing duodenoscope may be helpful for these patients. We report our experiences in the insertion of SEMSs to distal duodenum with a side-viewing endoscope.Methods: We retrospectively analyzed our database of SEMS placement for malignant distal duodenum obstruction between April 2006 and April 2013. All patients underwent SEMS placement using the side-viewing endoscope (duodenoscope). Main outcomes are technical success, clinical success, complication rates, stent patency, and overall survival. In addition, database from other tertiary center was analyzed, where SEMS insertion was performed with forward-viewing endoscopes (gastroscope or colonoscope). Success and complication rates were compared with ours.Results: A total of 31 patients were reviewed. Pancreatic cancer was the most common cause (87.1 {\%}). Technical and clinical success was achieved in all cases. Procedure-related complication occurred in one patient, who experienced micro-perforation of the duodenum. The patient improved with conservative treatment. Median duration of stent patency was 125 days (95 {\%} CI 75–175), and median overall survival was 134 days (95 {\%} CI 77–191). Biliary obstruction was present in 12.9 {\%} of patients, who underwent biliary stent placement at the same time without changing endoscopes. In forward-viewing endoscopes group, 15 cases were included. Technical and clinical success was achieved in all cases, and no procedure-related complication occurred.Conclusions: The insertion of SEMSs to distal duodenum with a duodenoscope could be performed effectively and safely in patients with malignant obstruction.",
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Feasibility of Self-Expandable Metal Stent Placement with Side-Viewing Endoscope for Malignant Distal Duodenal Obstruction. / Park, Jin Myung; Min, Byung Hoon; Lee, Sang Hyub; Chung, Kwang Hyun; Lee, Jae Min; Song, Byeong Jun; Lee, Jun Kyu; Ryu, Ji Kon; Kim, Young-Tae.

In: Digestive Diseases and Sciences, Vol. 60, No. 2, 01.01.2015, p. 524-530.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Feasibility of Self-Expandable Metal Stent Placement with Side-Viewing Endoscope for Malignant Distal Duodenal Obstruction

AU - Park, Jin Myung

AU - Min, Byung Hoon

AU - Lee, Sang Hyub

AU - Chung, Kwang Hyun

AU - Lee, Jae Min

AU - Song, Byeong Jun

AU - Lee, Jun Kyu

AU - Ryu, Ji Kon

AU - Kim, Young-Tae

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N2 - Background and Aim: Self-expandable metal stents (SEMSs) have been a good treatment option for malignant intestinal obstruction. However, stent placement with a gastroscope can be technically difficult for the distal duodenum obstruction. A side-viewing duodenoscope may be helpful for these patients. We report our experiences in the insertion of SEMSs to distal duodenum with a side-viewing endoscope.Methods: We retrospectively analyzed our database of SEMS placement for malignant distal duodenum obstruction between April 2006 and April 2013. All patients underwent SEMS placement using the side-viewing endoscope (duodenoscope). Main outcomes are technical success, clinical success, complication rates, stent patency, and overall survival. In addition, database from other tertiary center was analyzed, where SEMS insertion was performed with forward-viewing endoscopes (gastroscope or colonoscope). Success and complication rates were compared with ours.Results: A total of 31 patients were reviewed. Pancreatic cancer was the most common cause (87.1 %). Technical and clinical success was achieved in all cases. Procedure-related complication occurred in one patient, who experienced micro-perforation of the duodenum. The patient improved with conservative treatment. Median duration of stent patency was 125 days (95 % CI 75–175), and median overall survival was 134 days (95 % CI 77–191). Biliary obstruction was present in 12.9 % of patients, who underwent biliary stent placement at the same time without changing endoscopes. In forward-viewing endoscopes group, 15 cases were included. Technical and clinical success was achieved in all cases, and no procedure-related complication occurred.Conclusions: The insertion of SEMSs to distal duodenum with a duodenoscope could be performed effectively and safely in patients with malignant obstruction.

AB - Background and Aim: Self-expandable metal stents (SEMSs) have been a good treatment option for malignant intestinal obstruction. However, stent placement with a gastroscope can be technically difficult for the distal duodenum obstruction. A side-viewing duodenoscope may be helpful for these patients. We report our experiences in the insertion of SEMSs to distal duodenum with a side-viewing endoscope.Methods: We retrospectively analyzed our database of SEMS placement for malignant distal duodenum obstruction between April 2006 and April 2013. All patients underwent SEMS placement using the side-viewing endoscope (duodenoscope). Main outcomes are technical success, clinical success, complication rates, stent patency, and overall survival. In addition, database from other tertiary center was analyzed, where SEMS insertion was performed with forward-viewing endoscopes (gastroscope or colonoscope). Success and complication rates were compared with ours.Results: A total of 31 patients were reviewed. Pancreatic cancer was the most common cause (87.1 %). Technical and clinical success was achieved in all cases. Procedure-related complication occurred in one patient, who experienced micro-perforation of the duodenum. The patient improved with conservative treatment. Median duration of stent patency was 125 days (95 % CI 75–175), and median overall survival was 134 days (95 % CI 77–191). Biliary obstruction was present in 12.9 % of patients, who underwent biliary stent placement at the same time without changing endoscopes. In forward-viewing endoscopes group, 15 cases were included. Technical and clinical success was achieved in all cases, and no procedure-related complication occurred.Conclusions: The insertion of SEMSs to distal duodenum with a duodenoscope could be performed effectively and safely in patients with malignant obstruction.

KW - Duodenal obstruction

KW - Duodenoscopes

KW - Gastrointestinal neoplasms

KW - Stents

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