Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Efficacy of hemostasis by gastroduodenal covered metal stent placement for hemorrhagic duodenal stenosis due to pancreatobiliary cancer invasion: a retrospective study

  • Yasunari Sakamoto (Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital) ;
  • Taku Sakamoto (Endoscopy Division, National Cancer Center Hospital) ;
  • Akihiro Ohba (Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital) ;
  • Mitsuhito Sasaki (Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital) ;
  • Shunsuke Kondo (Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital) ;
  • Chigusa Morizane (Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital) ;
  • Hideki Ueno (Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital) ;
  • Yutaka Saito (Endoscopy Division, National Cancer Center Hospital) ;
  • Yasuaki Arai (Department of Diagnostic Radiology, National Cancer Center Hospital) ;
  • Takuji Okusaka (Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital)
  • Received : 2023.06.18
  • Accepted : 2024.01.15
  • Published : 2024.09.30
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Abstract

Background/Aims: Advanced pancreatic and biliary tract cancers can invade the duodenum and cause duodenal hemorrhagic stenosis. This study aimed to evaluate the efficacy of covered self-expandable metal stents in the treatment of cancer-related duodenal hemorrhage with stenosis. Methods: Between January 2014 and December 2016, metal stents were placed in 51 patients with duodenal stenosis. Among these patients, a self-expandable covered metal stent was endoscopically placed in 10 patients with hemorrhagic duodenal stenosis caused by pancreatobiliary cancer progression. We retrospectively analyzed the therapeutic efficacy of the stents by evaluating the technical and clinical success rates based on successful stent placement, degree of oral intake, hemostasis, stent patency, and overall survival. Results: The technical and clinical success rates were 100%. All 10 patients achieved a gastric outlet obstruction scoring system score of three within two weeks after the procedure and had no recurrence of melena. The median stent patency duration and overall survival after stent placement were 52 days (range, 20-220 days) and 66.5 days (range, 31-220 days), respectively. Conclusions: Endoscopic placement of a covered metal stent for hemorrhagic duodenal stenosis associated with pancreatic or biliary tract cancer resulted in duodenal hemostasis, recanalization, and improved quality of life.

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References

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