Application of catheter and guidewire transmission technology in the reconstruction of gastroduodenal malignant stricture

Abstract

Gastroduodenal obstruction is a preterminal event in patients with advanced and recurrent malignancies of the stomach, pancreas, and duodenum. It severely limits the quality of life in affected patients due to constant vomiting and associated malnutrition. Gastroduodenal stent placement is a very safe and effective method in patients with unresectable malignant tumors. Thirty-six patients with malignant gastroduodenal stenosis accompanied by gastrointestinal obstruction which was not traversable with a gastroscope were included in the study. Under X-ray monitoring, the catheter was inserted through the stenosis advancing with loach guidewire, which was later replaced by a stiff guidewire. A tri-lumen gastrojejunal catheter was then introduced using the stiff guidewire through the stenosis to perform gastrointestinal decompression and provide intestinal nutrition. In some patients, an intestinal stent was placed at the site of the stenosis. Intubation was successful in 35 patients out of 36. A total of 12 intestinal stents were successfully placed, including two at the pylorus, six at the site of gastrointestinal anastomosis, and four at the descending horizontal part of the duodenum. Establishing enteral nutrition via intubation using guidewire and catheter delivery technology is a simple, effective and safe strategy for patients with gastroscopic inaccessible malignant gastroduodenal stenosis, and it is recommended in hospital practice.