Abstract
Malignant dual obstruction in the common bile duct and gastric outlet-duodenum can cause difficulties in palliative treatment. The purpose of this study was to summarize our successful experience with the endoscopic stenting procedure for the palliative treatment of malignant biliary and gastric outlet-duodenum obstruction. Seventeen patients who underwent dual stenting procedures for the common bile duct and duodenum were retrospectively reviewed. The success rate of placement, palliative effect for biliary and duodenal obstruction, incidence of complication and restricture and stent patency were analyzed. Stent placement achieved a 100% success rate. Total bilirubin decreased from 263.4±62.5 to 157.6±25.1 μmol/l, direct bilirubin decreased from 233.2±66.5 to 130.9±27.7 μmol/l and alkaline phosphatase from 534.2±78.7 to 216.3±23.3 IU/l. The differences between the preoperative and postoperative results were statistically significant (P<0.01). The gastric outlet obstruction score increased significantly from 0.9±1.1 to 2.1±0.7 points (P<0.01). The general nutritional status of the patients was improved. No serious complications occurred in any of the patients, and the survival time of patients following stenting ranged between 70 and 332 days with a mean survival time of 192 days. In conclusion, our methodology for combined biliary and enteral stenting is highly effective for the palliation of malignant biliary and gastric outlet-duodenal obstruction.
Highlights
Malignant dual obstruction in the common bile duct and gastric outlet‐duodenum can cause difficulties in palliative treatment
Since the introduction of the self‐expanding metal stent (SEMS), stent placement has become the preferred option in clinical palliative management [4,5]
Since extension of the duodenoscope to the duodenal papilla is made difficult by gastric outlet obstruction (GOO), this practice has become unpopular in clinics
Summary
Malignant dual obstruction in the common bile duct and gastric outlet‐duodenum can cause difficulties in palliative treatment. The purpose of this study was to summarize our successful experience with the endoscopic stenting procedure for the palliative treatment of malignant biliary and gastric outlet‐duodenum obstruction. Our experience in applying endoscopic biliary and duodenal stenting in 17 patients was summarized and the techniques used to obtain a satisfactory clinical outcome were described. It is not uncommon in clinical settings to encounter patients with combined malignant gastric outlet obstruction (GOO)
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