EXPERIENCE OF USING PYLORODUODENAL STENTING IN CANCER PATIENTS

Aims With the progression of cancer, there is often a violation of patency in the stomach and duodenum. This leads to a loss of protein (hypoproteinemia) in the body, which in turn can lead to protein-free swelling on the legs and deterioration of the patient. Pyloroduodenal stenting can is a manipulation of choice.

Methods The study included 181 gastric outlets stenting in 156 patients for five years. After stenting systemic chemotherapy were planned without mention of curative surgery. There were 103 patients (66%) with distal stomach stenosis; 45 patients (28.9%) with pancreatic tumor involving of the duodenum and 8 patients (5.1%) with tumor compression of the area from the outside. The stent was placed once in 136, twice – in 15, three times – in 5 cases. We used uncovered pyloroduodenal or colorectal stents for the primary stenting. The cause of repeated stenting was tumor ingrowth into the stent with secondary stenosis formation we met in 15 cases. In these cases, covered or partially covered stents of the same length or longer.

Results Technical success of primary stenting was in 100%, clinical success – in 137 cases of stenting (87.8%). The maximum period of observation was 19 months. Early complications were noted in 16 cases (10.3%), among them: migration of the stent- 12, pain syndrome – 2, pancreatitis – 1 and tumor perforation – 1. These complications were not the reason for emergency surgical interventions, some of them were stopped by conservative methods, or repeated endoscopic interventions were required.

Conclusions It a safe option for the patients, who are not candidates for curative surgery.