CLINICAL EVALUATION OF METALLIC STENTING FOR MALIGNANT DUODENAL OBSTRUCTION USING COVERED SELF-EXPANDABLE METALLIC STENT

Covered self-expandable metallic stent (SEMS) prevents tumor ingrowth and hyperplasia, and allows long-term patency. However, covered SEMS has rarely been used for malignant duodenal obstruction. In the present study, we applied a covered SEMS for malignant duodenal obstruction, aiming at prevention of tumor ingrowth and hyperplasia and long-term patency, and performed clinical evaluation. The original disease was pancreas cancer in 23 patients, gallbladder cancer in two, bile duct cancer in two, Vater's papilla cancer in one, duodenal cancer in two, and metastatic tumor (uterine cancer) in one. Treatment of duodenal obstruction using a covered SEMS was successful in 30 of the 31 patients. The patients were able to ingest orally within a mean of 2 days, and 90% of the patients (27/30) were able to eat solid diets later. None of the patients reported a symptom due to obstruction of the SEMS until death. The mean duration of patency of the duodenal covered SEMS was 175 days (SD: ± 114 days). We concluded that palliative thrapy using a covered SEMS for malignant duodenal obstruction obtained good patency and it was useful thrapy.