Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Cardiovasc Intervent Radiol. 2012 Oct;35(5):1129-35. doi: 10.1007/s00270-011-0262-3. Epub 2011 Sep 1.
To evaluate the clinical effectiveness of self-expandable metallic stents in seven patients with malignant gastroduodenal obstruction caused by inoperable hepatocellular carcinoma (HCC).
Seven patients with gastroduodenal obstruction caused by advanced HCC underwent metallic stent placement from 2003 to 2010. These patients had total dysphagia (n = 5) or were able to eat only liquids (n = 2) before stent placement. Patients had Eastern Cooperative Oncology Group performance scores of 2 or 3, and Child-Pugh classification B or C.
Stent placement was technically successful in all seven patients (100%) and clinically successful in six (86%). Five patients could eat a soft diet, and one patient tolerated regular diet after stent placement. Stent-related obstructive jaundice occurred in one patient. One patient had hematemesis 11 days after stent placement. Overall mean survival was 51 days (range, 10-119 days). Stent patency was preserved in six patients with clinical success until death.
Placement of a covered self-expandable metallic stent may offer good palliation in patients with gastroduodenal obstruction due to advanced HCC.
评估不可切除肝细胞癌（HCC）引起的恶性胃十二指肠梗阻的 7 例患者中使用自膨式金属支架的临床疗效。
2003 年至 2010 年，7 例胃十二指肠梗阻的 HCC 患者接受了金属支架置入术。这些患者在支架置入前存在完全吞咽困难（n=5）或仅能进食液体（n=2）。患者的东部肿瘤协作组（ECOG）体能状态评分为 2 或 3 分，Child-Pugh 分级为 B 或 C 级。
7 例患者（100%）的支架置入技术均成功，6 例（86%）的支架置入临床有效。5 例患者可进食软食，1 例患者支架置入后可耐受普通饮食。1 例患者发生支架相关阻塞性黄疸。1 例患者支架置入后 11 天出现呕血。总平均生存时间为 51 天（范围 10-119 天）。6 例具有临床疗效的患者的支架通畅性保持至死亡。
对于因晚期 HCC 引起的胃十二指肠梗阻患者，覆盖自膨式金属支架的置入可能提供良好的姑息治疗效果。
