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PTU-036 Endoscopic Management of Malignant Gastric Outlet Obstruction: Results from a Newly Created Regional Cancer Service
  1. D Ismail1,
  2. J Deacon2,
  3. B Macfarlane1,
  4. D L Morris2,
  5. M Fullard1,
  6. I Sargeant2,
  7. J Evans1,
  8. A Leahy1
  1. 1Department of Gastroenterology, West Hertfordshire Hospitals NHS Trust
  2. 2Department of Gastroenterology, East and North Hertfordshire Hospitals NHS Trust, Watford, UK

Abstract

Introduction Malignant gastric outlet obstruction can be a distressing medical condition leading to considerable morbidity with a well recognised poor prognosis. Previous studies (mostly outside of the UK) have shown that endoscopic insertion of a duodenal stent can alleviate the obstructive symptoms to good effect (1–3). In 2009, we set up a regional service for duodenal stent insertion with an aim to replicate these results across a UK upper gastro-intestinal cancer network (catchment area 1.4 million).

Methods A retrospective analysis was performed in patients who had an endoscopically placed duodenal stent for inoperable cancer causing mechanical gastric outlet obstruction. We reviewed hospital/endoscopy electronic records regarding patient demographics, length of hospital stay after the procedure, endoscopy re-intervention and survival.

Results Between July 2009 and November 2012 a total of 27 patients underwent duodenal stent (uncovered WallFlex®, Boston Scientific) insertion. 15 were men, mean age of 70.6 years (range 27–86). 23/27 (85%) patients were discharged home after the procedure, 2 were transferred to a hospice and 2 died in hospital. The average length of hospital stay after the procedure was 5.7 days (range 0–25).

Endoscopy re-intervention was performed in 2 patients for stent occlusion requiring further stent insertion. 22 patients have been followed until death with a mean survival period of 12.5 weeks (range 1–34). 5 patients remain alive at the time of abstract submission.

Conclusion Duodenal stent insertion offered a good palliative option in most of our patients. Our patient outcomes compared favourably to previous published studies.

Disclosure of Interest None Declared

References

  1. ASGE Technology Committee. The role of endoscopy in gastroduodenal obstruction and gastroparesis. Gastrointest Endosc 2011; 74(1):13–21.

  2. Sasaki T, Isayama H, Maetani I et al. Japanese multicenter estimation of wallflex duodenal stent for unresectable malignant gastric outlet obstruction Dig Endosc 2013 25(1):1–6.

  3. Costamagna G, Tringali A, Spicak J et al. Treatment of malignant gastroduodenal obstruction with a nitinol self-expanding metal stent: an international prospective multicentre registry. Dig Liver Dis 2012 44(1):37–43.

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