Abstract
Background Niti-S duodenal stent (Century Medical, Inc.) have been used as a modality for the palliative treatment in patients with malignant gastroduodenal obstruction since 2012. We investigated the efficacy, safety, nutritional condition and the prognosis treated with the Niti-S duodenal stent. Methods We have treated 23 patients with inoperable malignant gastroduodenal obstruction using Niti-S duodenal stents since May 2012. We evaluated the technical or clinical success rate, procedure time, maintained the oral intake period and the nutritional status. Oral intake was assessed by the gastric outlet obstruction scoring system (GOOSS) and the nutritional status was measured by Onodera's prognostic nutritional index (PNI) before and after treatment. We also investigated the stent patency, complications and the prognosis. Results There were 15 males and 8 females and average age was 78.2 years old. The primary diseases were 14 gastric cancer, 4 pancreatic cancer, 2 bile duct cancer, 2 duodenal cancer and an ampullary cancer. Fifteen patients had carcinomatous peritonitis. The technical and clinical success rates were 100% and 87%. The average procedure time was 14.8 minutes. Four patients had double stenting with biliary stent. The GOOSS was significantly improved from 0.5 to 2.4 (p<0.001) after the stent placement. The average maintained the oral intake period was 87.6 days and survival time was 95.5 days. The PNI and the mean survival time (MST) was improved in the GOOSS 3 group compared with 2 or less group (PNI: 32.0 vs 22.8, p<0.01, MST: 111.7 days vs 34.2 days, p<0.05). Re-intervention was required in a patient. The major complication was not observed. Conclusions Niti-S duodenal stent was effective and safe from malignant gastroduodenal obstruction. The patient's nutritional status and prognosis were improved after the stent placement. Legal entity responsible for the study Nagoya Medical Center Funding Nagoya Medical Center Disclosure All authors have declared no conflicts of interest.
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