목적: 위․십이지장관 스텐트의 효과를 악성 12지장협착 환자의 고식적 치료의 효과를 알아보고자 한다. 방법 및 결과: 방사선투시하에서 남자환자 44명 여자환자 22명 총 66명의 환자에 장치하였으며 평균연령은 63세이었고 모두 음식을 섭취곤란증과 구토 증상이 ...

목적: 위․십이지장관 스텐트의 효과를 악성 12지장협착 환자의 고식적 치료의 효과를 알아보고자 한다. 방법 및 결과: 방사선투시하에서 남자환자 44명 여자환자 22명 총 66명의 환자에 장치하였으며 평균연령은 63세이었고 모두 음식을 섭취곤란증과 구토 증상이 있었고 치료목적의 수술이 불가능한 환자들이었다. 결과: 시술 성공률은 93%이었고 시술에 성공한 62명 중 59명이 음식섭취와 구토 증상이 호전되었다. 시술 후 평균 73.6일(9-370일) 동안 7명의 환자에서 증상의 재발이 있었는데 원인은 종양의 성장이었고 이는 스텐트를 하나 더 포개 넣는 방식으로 해결하였다. 1,3,6개월 개통율은 각각 96.1%, 81.0%, 37.7%이었다. 결론: 위․십이지장관 스텐트는 악성 12지장협착 환자의 고식적 치료에 매우 효과가 있다고 사료된다.

PURPOSE: To assess the efficacy and complications of self-expandable nitinol stents in the palliative treatment of malignant duodenal obstructions.MATERIALS AND METHODS:Under fluoroscopic guidance, 66 patients (44 male and 22 female, mean age 63.0 yea ...

PURPOSE: To assess the efficacy and complications of self-expandable nitinol stents in the palliative treatment of malignant duodenal obstructions.MATERIALS AND METHODS:Under fluoroscopic guidance, 66 patients (44 male and 22 female, mean age 63.0 years) with malignant duodenal obstructions,were treated with peroral placement of four types of self-expandable nitinol stents. All patients presented with severe nausea and recurrent vomiting, and their obstructions were inoperable. RESULTS: Technical success was achieved in 62 of 66 patients (93.9%). After stent placement, food intake capacity improved in 59 of 62 patients (95.2%). Stent migration occurred in one patient four days after placement. A covered stent was placed over the ampullar of Vater in eight patients without external biliary drainage, three of whom(37.5%) became jaundiced. During the mean follow-up of 73.6 days (9-370 days), seven patients developed recurrent obstructive symptoms caused by tumor ingrowth (n=2) or tumor overgrowth (n=5) they were successfully treated with additional stent placement. The primary stent patency rates were 96.1%, 81.0%, and 37.8% at one, three, and six months, respectively. CONCLUSIONS: Fluoroscopic peroral placement of self-expandable nitinol stents is an effective palliative treatment for malignant duodenal obstructions.

PURPOSE: To assess the efficacy and complications of self-expandable nitinol stents in the palliative treatment of malignant duodenal obstructions.MATERIALS AND METHODS:Under fluoroscopic guidance, 66 patients (44 male and 22 female, mean age 63.0 yea ...

PURPOSE: To assess the efficacy and complications of self-expandable nitinol stents in the palliative treatment of malignant duodenal obstructions.MATERIALS AND METHODS:Under fluoroscopic guidance, 66 patients (44 male and 22 female, mean age 63.0 years) with malignant duodenal obstructions,were treated with peroral placement of four types of self-expandable nitinol stents. All patients presented with severe nausea and recurrent vomiting, and their obstructions were inoperable.
RESULTS: Technical success was achieved in 62 of 66 patients (93.9%). After stent placement, food intake capacity improved in 59 of 62 patients (95.2%). Stent migration occurred in one patient four days after placement. A covered stent was placed over the ampullar of Vater in eight patients without external biliary drainage, three of whom(37.5%) became jaundiced. During the mean follow-up of 73.6 days (9-370 days), seven patients developed recurrent obstructive symptoms caused by tumor ingrowth (n=2) or tumor overgrowth (n=5) they were successfully treated with additional stent placement. The primary stent patency rates were 96.1%, 81.0%, and 37.8% at one, three, and six months, respectively.
CONCLUSIONS: Fluoroscopic peroral placement of self-expandable nitinol stents is an effective palliative treatment for malignant duodenal obstructions.

In our study, all patients had severe obstructive symptoms prior tostent placement. 87.1% (45 of 62) of these patients were able to tolerate nothing perorally. The obstructive symptoms of our patients seemed to be more severe than those of patients wi ...

In our study, all patients had severe obstructive symptoms prior tostent placement. 87.1% (45 of 62) of these patients were able to tolerate nothing perorally. The obstructive symptoms of our patients seemed to be more severe than those of patients with gastric outlet obstructions in previous studies in which the mean dysphagia score of the patients were 2.0-2.5 as scored using a similar scoring system. However, after stent placement, improvement of food intake capacity was noted in 95.2% of our patients (59 of 62)and 79.0% (49 of 62) of the patients showed improvement of equal or more than 2 grades of the dysphagia score.
In conclusion, fluoroscopic peroral placement of a self-expandable metallic stent is an effective palliative treatment for malignant duodenal obstruction. Technical success can be achieved in almost all patients using low profile and highly flexible stents obstructive symptoms subsequently improve in most patients.