Endoscopy 2011; 43(8): 671-675
DOI: 10.1055/s-0030-1256383
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Safety and efficacy of a new non-foreshortening nitinol stent in malignant gastric outlet obstruction (DUONITI study): a prospective, multicenter study

J.  E.  van Hooft1 , M.  L.  van Montfoort1 , S.  M.  Jeurnink2 ,  4 , M.  J.  Bruno1 ,  2 , M.  G.  Dijkgraaf3 , P.  D.  Siersema2 ,  4 , P.  Fockens1
  • 1Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  • 2Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
  • 3Clinical Research Unit, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  • 4Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
Further Information

Publication History

submitted 29 July 2010

accepted after revision 2 March 2011

Publication Date:
07 June 2011 (online)

Background and study aims: Gastric outlet obstruction (GOO) is a late complication of advanced gastric, periampullary, and duodenal malignancies. Palliation of obstruction is the primary aim of treatment in these patients. Self-expandable metal stents have emerged as a promising treatment option. Our aim was to investigate the safety and efficacy of a new non-foreshortening nitinol duodenal stent.

Patients and methods: A total of 52 patients with symptomatic malignant GOO were studied in this prospective multicenter cohort study. All patients received a D-Weave Niti-S duodenal stent (Taewoong Medical, Seoul, South Korea). Patients were followed up until withdrawal of informed consent or death.

Results: The cause of GOO was pancreatic cancer in the majority of patients (62 %). The technical and clinical success rates were 96 % and 77 %, respectively. The GOO Scoring System score improved significantly (P < 0.0001) when the scores before stenting were compared with the mean scores until death. Median survival was 82 days and stent patency was observed in 75 % for up to 190 days, accounting for death as a competing risk. In 13 patients (25 %) stent dysfunction occurred (tumor ingrowth in 11, stent migration in two). Over time, the body mass index, the World Health Organization performance score, and the EuroQol visual analog scale revealed a not significant change (P = 0.52, P = 0.43, and P = 0.15, respectively), whereas the global health status improved significantly (P = 0.001).

Conclusion: Placement of a new non-foreshortening nitinol enteral stent is safe and without major complications. This stent design produces significant relief of obstructive symptoms and improves quality of life in patients with incurable malignant GOO.

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J. E. van HooftMD 

Department of Gastroenterology and Hepatology
Academic Medical Center
University of Amsterdam

Meibergdreef 9
1105 AZ Amsterdam
The Netherlands

Fax: +31-20-6917033

Email: J.E.vanhooft@amc.nl