Sasaki Reina, Sakai Yuji, Tsuyuguchi Toshio, Nishikawa Takao, Fujimoto Tatsuya, Mikami Shigeru, Sugiyama Harutoshi, Yokosuka Osamu
Reina Sasaki, Yuji Sakai, Toshio Tsuyuguchi, Takao Nishikawa, Harutoshi Sugiyama, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
World J Gastroenterol. 2016 Apr 14;22(14):3837-44. doi: 10.3748/wjg.v22.i14.3837.
To determine the safety and efficacy of endoscopic duodenal stent placement in patients with malignant gastric outlet obstruction.
This prospective, observational, multicenter study included 39 consecutive patients with malignant gastric outlet obstruction. All patients underwent endoscopic placement of a nitinol, uncovered, self-expandable metal stent. The primary outcome was clinical success at 2 wk after stent placement that was defined as improvement in the Gastric Outlet Obstruction Scoring System score relative to the baseline.
Technical success was achieved in all duodenal stent procedures. Procedure-related complications occurred in 4 patients (10.3%) in the form of mild pneumonitis. No other morbidities or mortalities were observed. The clinical success rate was 92.3%. The mean survival period after stent placement was 103 d. The mean period of stent patency was 149 d and the patency remained acceptable for the survival period. Stent dysfunction occurred in 3 patients (7.7%) on account of tumor growth.
Endoscopic management using duodenal stents for patients with incurable malignant gastric outlet obstruction is safe and improved patients' quality of life.
确定内镜下十二指肠支架置入术治疗恶性胃出口梗阻患者的安全性和有效性。
这项前瞻性、观察性、多中心研究纳入了39例连续性恶性胃出口梗阻患者。所有患者均接受了镍钛合金无覆膜自膨式金属支架的内镜置入术。主要结局是支架置入后2周的临床成功，定义为胃出口梗阻评分系统评分相对于基线有所改善。
所有十二指肠支架置入手术均取得技术成功。4例患者（10.3%）发生了与手术相关的并发症，表现为轻度肺炎。未观察到其他发病或死亡情况。临床成功率为92.3%。支架置入后的平均生存期为103天。支架通畅的平均时间为149天，在生存期内通畅情况仍可接受。3例患者（7.7%）因肿瘤生长出现支架功能障碍。
对于无法治愈的恶性胃出口梗阻患者，采用十二指肠支架进行内镜治疗是安全的，并且改善了患者的生活质量。
