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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2009

Open Access 01-12-2009 | Research article

Treatment of malignant gastric outlet obstruction with stents: An evaluation of the reported variables for clinical outcome

Authors: Lene Larssen, Asle W Medhus, Truls Hauge

Published in: BMC Gastroenterology | Issue 1/2009

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Abstract

Background

Malignant gastric outlet obstruction (GOO) is commonly seen in patients with advanced gastric-, pancreatic-, duodenal, hepatobiliary or metastatic malignancies. Ten to 25% of patients with pancreatic cancer will develop duodenal obstruction during the course of the disease. Duodenal stenting with self-expandable metal stents is an alternative treatment to surgical bypass procedures. Our aim was to review the published literature regarding treatment of malignant GOO with stents to reveal whether the information provided is sufficient to evaluate the clinical effects of this treatment

Methods

A literature search from 2000 – 2007 was conducted in Pub Med, Embase, and Cochrane library, combining the following search terms: duodenal stent, malignant duodenal obstruction, gastric outlet obstruction, SEMS, and gastroenteroanastomosis.
All publications presenting data with ≥ 15 patients and only articles written in English were included and a review focusing on the following parameters were conducted: 1) The use of graded scoring systems evaluating clinical success; 2) Assessment of Quality of life (QoL) before and after treatment; 3) Information on stent-patency; 4) The use of objective criteria to evaluate the stent effect.

Results

41 original papers in English were found; no RCT's. 16 out of 41 studies used some sort of graded scoring system. No studies had objectively evaluated QoL before or after stent treatment, using standardized QoL-questionnaires, 32/41 studies reported on stent patency and 9/41 performed an oral contrast examination after stent placement. Objective quantitative tests of gastric emptying had not been performed.

Conclusion

Available reports do not provide sufficient relevant information of the clinical outcome of duodenal stenting. In future studies, these relevant issues should be addressed to allow improved evaluation of the effect of stent treatment.
Appendix
Available only for authorised users
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Metadata
Title
Treatment of malignant gastric outlet obstruction with stents: An evaluation of the reported variables for clinical outcome
Authors
Lene Larssen
Asle W Medhus
Truls Hauge
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2009
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/1471-230X-9-45

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Keynote webinar | Spotlight on medication adherence

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Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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