Johnston S D, McKelvey S T D, Moorehead R J, Spence R A J, Tham T C K
The Ulster Hospital, Division of Gastroenterology, Dundonald, Belfast.
Ulster Med J. 2002 May;71(1):30-3.
Duodenal obstruction may be caused by inoperable malignant disease. Symptoms of nausea and vomiting have been traditionally palliated by surgery. The aim of the study was to determine the efficacy of the endoscopic placement of metal self expanding duodenal stents for the palliation of malignant duodenal obstruction. Four patients with malignant gastric outlet obstruction are described. One patient had a history of oesophagectomy for oesophageal adenocarcinoma and presented with further dysphagia. At endoscopy the recurrent oesophageal tumour and an adenocarcinoma involving the pylorus were both stented. In the other three patients there was a previous history of colonic carcinoma, cholangiocarcinoma and oesophageal adenocarcinoma respectively. All four patients were successfully stented with good palliation of their symptoms. Duodenal Wallstents are a useful alternative to surgery in patients with inoperable malignant duodenal obstruction or those who are unfit for surgery.
十二指肠梗阻可能由无法手术的恶性疾病引起。恶心和呕吐症状传统上通过手术缓解。本研究的目的是确定内镜下放置金属自膨式十二指肠支架缓解恶性十二指肠梗阻的疗效。描述了4例恶性胃出口梗阻患者。1例患者有因食管腺癌行食管切除术史，现出现进一步吞咽困难。在内镜检查时，复发性食管肿瘤和累及幽门的腺癌均置入了支架。另外3例患者分别有结肠癌、胆管癌和食管腺癌病史。所有4例患者均成功置入支架，症状得到良好缓解。对于无法手术的恶性十二指肠梗阻患者或不适合手术的患者，十二指肠壁支架是手术的一种有用替代方法。
