Outcomes of patients with malignant duodenal obstruction after receiving self-expandable metallic stents: A single center experience

• Published in: PloS one Vol. 17; no. 5; p. e0268920
• Main Authors: Tien-Hsin Wei, Bing-Wei Ye, Pei-Shan Wu, Chung-Pin Li, Yee Chao, Pei-Chang Lee, Yi-Hsiang Huang, Kuei-Chuan Lee, Ming-Chih Hou
• Format: Journal Article
• Language: English
• Published: Public Library of Science (PLoS) 01.01.2022
• ISSN: 1932-6203
• DOI: 10.1371/journal.pone.0268920

ObjectivesSelf-expandable metallic stent (SEMS) placement is a safe and effective palliative treatment for malignant gastric outlet obstruction; however, the clinical outcomes of gastric and duodenal stenoses may differ. This study aimed to investigate the clinical efficacy of SEMS placement and the predictors of clinical outcomes, specifically in malignant duodenal obstruction (MDO).MethodsBetween September 2009 and March 2021, 79 patients with MDO who received SEMS placement in our hospital were retrospectively enrolled. Patients were divided into three groups according to the obstruction levels: above-papilla group (type 1), papilla involved group (type 2), and below-papilla group (type 3). The clinical outcomes and predictors of survival and restenosis were analyzed.ResultsThe technical and clinical success rates were 97.5% and 80.5%, respectively. Among patients who had successful stent placement, stent restenosis occurred in 17 patients (22.1%). The overall median stent patency time was 103 days. The overall median survival time after stent placement was 116 days. There was no difference in the stent patency, or stent dysfunction and procedure-related adverse events among the three groups. A longer length of duodenal stenosis ≥ 4 cm was associated with poor prognosis (hazard ratio [HR] = 1.92, 95% confidence interval [CI] = 1.06-3.49, p = 0.032) and post-stent chemotherapy was associated with lower mortality (HR = 0.33; 95% CI = 0.17-0.63, p = 0.001).ConclusionSEMS is a safe and effective treatment for MDO. Chemotherapy after SEMS implantation improve the survival for these patients and a longer length of stenosis predicts higher mortality.