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Semin intervent Radiol 2004; 21(3): 167-179
DOI: 10.1055/s-2004-860875
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Gastroduodenal Stenting

Derrick F. Martin1 , Hans-Ulrich Laasch2
  • 1Professor, Academic Department of GI-Radiology, South Manchester University Hospitals and University of Central Lancashire, Manchester, United Kingdom
  • 2Department of Clinical Radiology, Central Manchester University Hospitals, Manchester, United Kingdom
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Publication History

Publication Date:
16 December 2004 (online)

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ABSTRACT

Palliative procedures for patients with malignant gastroduodenal obstruction must be readily available, have a rapid onset of action, and be well tolerated by a patient with terminal cancer. Laparoscopic gastroenterostomy and insertion of self-expanding stents are emerging as the current methods of choice.

An increasing number of dedicated enteral stents with different properties are now available. These can be placed under fluoroscopic guidance alone or with the help of an endoscope. Endoscopic placement has several advantages but requires good collaboration between the endoscopists and the radiology department. Appropriate imaging and work-up of each case at multidisciplinary meetings is required. Coexisting biliary obstruction may be dealt with endoscopically, but frequently requires percutaneous biliary stent placement prior to duodenal stenting. Reintervention is required in up to 25% of patients, usually due to stent occlusion by further tumor growth. This article suggests strategies for patient assessment, procedure planning, and stent insertion.

KEYWORDS

Gastroduodenal obstruction - pancreatic cancer - metallic stents

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 Prof.
Derrick F Martin

Academic Dept. of GI-Radiology, South Manchester University Hospitals and University of Central Lancashire

Southmoor Rd, Wythenshawe

Manchester M23 9LT, United Kingdom

Email: derrick.martin@smtr.nhs.uk