Outcome of self-expandable metallic stent deployment in patients with malignant gastroduodenal outlet obstruction and Niti-S and WallFlex comparison: a multicenter retrospective clinical study

Hironari Kato, Hirofumi Kawamoto, Kazuya Matsumoto, Ichiro Moriyama, Hideki Kamada, Koichiro Tsutsumi, Daisuke Goto, Nobuhiko Fukuba, Kiyohito Kato, Hiroki Sonoyama, Hajime Isomoto, Hiroyuki Okada

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives: Several studies report on the outcomes of self-expandable metallic stents (SEMSs) deployment for malignant gastric outlet obstruction (GOO). However, data was mostly based on the analysis of single-center studies including only a small number of patients. This study aimed to evaluate clinical outcomes after the deployment of SEMS in patients with malignant GOO and to compare the clinical outcomes of two metallic stents with different designs. Methods: Altogether 125 consecutive patients from five institutions were included. Clinical outcomes were evaluated according to technical success, clinical success, stent patency period, survival period and complications. A comparison of clinical outcomes between Niti-S pyloric/duodenal and WallFlex duodenal stents was also undertaken. Results: Rates for clinical and technical success were 100% and 92.0%, respectively. The median stent patency and survival periods were 72.0 days (range 3–775 days) and 75.0 days (range 3–775 days), respectively. The rate of overall adverse events was 28.8%. The rate of stent dysfunction was 16.8%, and that of adverse events, except stent dysfunction was 12.0%. Massive bleeding occurred in two patients as a late complication. The clinical success rate for Niti-S stent was significantly higher than that for WallFlex stent (96.2% vs 84.8%, P = 0.023). Conclusions: We successfully deployed a SEMS in malignant GOO. The selection of a SEMS with a lower axial force may be important for patients to resume the oral food intake. Additionally, consideration must be given to the appropriate management of fatal bleeding as a late complication.

Original languageEnglish
Pages (from-to)518-525
Number of pages8
JournalJournal of Digestive Diseases
Volume17
Issue number8
DOIs
Publication statusPublished - Aug 1 2016

Keywords

  • Niti-S
  • WallFlex
  • complication
  • gastric outlet obstruction
  • self-expandable metallic stent

ASJC Scopus subject areas

  • Gastroenterology

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