Журнал гепатологии и желудочно-кишечных расстройств
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Self-Expandable Metal Stents for the Management of Gastric Outlet Obstruction: Experience with Endoscopic Palliation in Patients from a Tertiary-Care Facility in Pakistan

AISHA RUMMAAN

Background and Aim: Gastric outlet obstruction is commonly considered as advanced malignancies of the stomach, duodenum, pancreas, hepatobiliary, and ampullary regions. It results in symptoms like persistent nausea/vomiting, dehydration, decreased oral intake, and weight loss. Surgical bypass and chemotherapy are usually the effective treatments employed to deal with the malignancy. Nonetheless, their high cost, more complications, and poor outcomes make the placement of self-expandable metal stents a good palliative option for symptomatic relief and improved quality of life. Therefore, a retrospective cohort study was conducted to determine the outcomes of self-expandable metal stents in patients with gastric outlet obstruction.

Methods: Forty-seven patients with gastric outlet obstruction who underwent self- expandable metal stents in Patel hospital, Karachi-Pakistan from January 2013 till January 2020 were included in the study. Data on improvement in food intake was the primary clinical success outcome which was measured by the gastric outlet obstruction score, rest being, complications, obstruction etiology, overall survival, and technical success were evaluated from patient’s follow-up and endoscopic database of the hospital department.

Results: Forty-seven symptomatic patients (n=47), received uncovered self- expandable stent placements during the study period with n=22 (46.8%) single stents, while, n=25 (53.2%) dual stents, with a mean ±SD (median) age of 60.6 (±14.1) years. Fifteen (31.9%) participants showed good improvement, n=23 (48.9%) patients showed mild improvements and n=04 (8.5%) reported moderate improvement, while only n=05 (10.6%) patients showed no improvements at all after placement of the intervention. Clinical success was considerable as n=22 (46.8%).

Conclusion: The endoscopic stenting for malignant gastric outlet obstruction appears to be a viable alternative to surgical palliative bypass.