1. Outcomes of enteral metallic stent in patients with pancreatic carcinoma and gastric outlet obstruction: A single center experience.
- Author
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Chang, Ke-Bin, Ye, Bing-Wei, Chou, Chung-Kai, Lee, I-Cheng, Li, Chung-Pin, Chao, Yee, Huang, Yi-Hsiang, Hou, Ming-Chih, and Lee, Kuei-Chuan
- Subjects
GASTRIC outlet obstruction ,DUODENAL obstructions ,GASTROENTEROSTOMY ,PANCREATIC cancer ,ASPIRATION pneumonia ,CARCINOMA ,PANCREATIC tumors ,TIME ,RETROSPECTIVE studies ,TREATMENT effectiveness ,PROPORTIONAL hazards models ,DISEASE complications - Abstract
Background: Duodenal obstruction is uncommon in patients with pancreatic cancer. However, the obstruction rate is increasing as a result of advancements in chemotherapy and target therapy. This study aimed to investigate the effect of self-expandable metal stent placement on outcomes of patients with duodenal obstruction secondary to pancreatic carcinoma.Methods: Twenty-nine consecutive inoperable patients with pancreatic cancer and gastric outlet obstruction who received metallic stent placement in our hospital between September 2009 and October 2017 were enrolled for analysis.Results: Fifteen male patients and 14 female patients receiving stent placement with a median age of 68 years (range, 50-85 years) were included. The technical and clinical success rates of the procedure were 100% and 89.7%, respectively. The Gastric Outlet Obstruction Scoring System scores were significantly improved at day 1 (1.14 ± 0.51) and days 7 (2.21 ± 0.9) after the implantation compared to those prior to the procedure (0.38 ± 0.49) (p < 0.001). Aspiration pneumonia and bleeding developed in 1 patient (3.4%) after the procedure. Stent dysfunction developed in 6 of 29 patients (20.6%). The median stent patency time was 109 days (range, 10-314 days). The median survival time was 114 days (range, 15-323 days). Post-stent chemotherapy predicted better survival (hazard ratio: 0.2, 95% confidence interval: 0.08-0.51, p = 0.001).Conclusion: Metallic stent placement is an effective treatment for patients with inoperable pancreatic cancer leading to gastric outlet obstruction. Chemotherapy may be considered following stent placement. [ABSTRACT FROM AUTHOR]- Published
- 2020
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