Endoscopy or surgery for malignant GI outlet obstruction?

Abstract

To the Editor: We read with interest the recent article by Del Piano et al1Del Piano M. Ballare M. Montino F. Todesco A. Orsello M. Magnani C. et al.Endoscopy or surgery for malignant GI outlet obstruction?.Gastrointest Endosc. 2005; 61: 421-426Abstract Full Text Full Text PDF PubMed Scopus (123) Google Scholar Overall, we agree with the content of the manuscript and are strong supporters of the use of self-expanding metal stents in patients with malignant gastric outlet obstruction. However, in Figure 2 of their manuscript, the investigators “propose” an algorithm for the treatment of gastric outlet obstruction. This figure is virtually identical in content, wording, and layout to an algorithm that we proposed (Fig. 4) for the management of gastric outlet obstruction over 3 years ago when we reported our results in a series of 36 patients with gastric outlet obstruction managed with self-expanding metal stents.2Adler D.G. Baron T.H. Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients.Am J Gastroenterol. 2002; 97: 72-78Crossref PubMed Google Scholar The similarities between these two figures are difficult to ignore. Our manuscript is not cited by Del Piano et al.1Del Piano M. Ballare M. Montino F. Todesco A. Orsello M. Magnani C. et al.Endoscopy or surgery for malignant GI outlet obstruction?.Gastrointest Endosc. 2005; 61: 421-426Abstract Full Text Full Text PDF PubMed Scopus (123) Google Scholar Based upon definitions outlined by Skandalakis and Mirilas,3Skandalakis J.E. Mirilas P. Plagiarism. Arch Surg. 2004; 139: 1022-1024Crossref PubMed Scopus (19) Google Scholar paraphrasing without crediting the source is considered plagiarism. Endoscopy or surgery for malignant GI outlet obstruction?Gastrointestinal EndoscopyVol. 61Issue 3PreviewThe treatment of gastroduodenal outflow obstruction (GOO) caused by malignant diseases represents a significant challenge. Open surgical gastrojejunostomy (GJ) has been the treatment of choice, but it has high morbidity and mortality rates. More recently, endoscopic placement of self-expanding metallic stents (SEMS) has been proposed and the results of small, preliminary studies are encouraging. This study compared technical and clinical success, morbidity, mortality, and hospital stay in patients undergoing endoscopic and surgical treatment of GOO. Full-Text PDF Response:Gastrointestinal EndoscopyVol. 62Issue 2PreviewWe have read the letter by Adler and Baron about the similarities of our algorithm for treatment of gastric outlet obstruction1 and the one they proposed 3 years ago.2 Full-Text PDF