Retrospective Study
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World J Gastroenterol. Nov 28, 2014; 20(44): 16721-16725
Published online Nov 28, 2014. doi: 10.3748/wjg.v20.i44.16721
Safety and efficacy of a partially covered self-expandable metal stent in benign pyloric obstruction
Jun Heo, Min Kyu Jung
Jun Heo, Min Kyu Jung, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu 700712, South Korea
Author contributions: Jung MK designed and performed the research; Heo J and Jung MK contributed new reagents/analytic tools and wrote the paper; Heo J analyzed the data.
Correspondence to: Min Kyu Jung, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 700712, South Korea. minky1973@hanmail.net
Telephone: +82-53-2005514 Fax: +82-53-4262046
Received: May 9, 2014
Revised: July 31, 2014
Accepted: September 5, 2014
Published online: November 28, 2014
Processing time: 206 Days and 21.3 Hours
Abstract

AIM: To evaluate the safety and efficacy of partially covered self-expandable metallic stents (SEMSs) in benign pyloric obstruction.

METHODS: We retrospectively analyzed data from 10 consecutive patients with peptic ulcer-related pyloric obstructive symptoms (gastric outlet obstruction scoring system (GOOSS) score of 1) between March 2012 and September 2013. The patients were referred to and managed by partially covered SEMS insertion in our tertiary academic center. We assessed the technical success, symptom improvement, and adverse events after stenting.

RESULTS: Early symptoms were improved just 3 d after SEMS placement in all 10 patients. The GOOSS score of all patients improved from 1 to 3. There were no serious immediate adverse events. The overall rate of being symptom free was 90% at a median of 11 mo of follow-up (range: 4-43 mo). Five patients were managed by a rescue SEMS because of failure of previous endoscopic balloon dilatation. Among them, four patients had sustained symptom improvement after the SEMS procedure. During the follow-up period, migration of the SEMS was observed in two patients (20.0%), both of whom had previous endoscopic balloon dilatation before SEMS insertion.

CONCLUSION: Despite the small number in this study, partially covered SEMSs showed a favorable and safe outcome in the treatment of naïve benign pyloric obstruction and in salvage treatment after balloon dilatation failure.

Keywords: Benign pyloric obstruction; Balloon dilatation; Self-expandable metallic stent; Gastric outlet obstruction scoring system

Core tip: Partially covered self-expandable metallic stents had a safe and favorable outcome in the treatment of naïve benign pyloric obstruction and in salvage treatment after balloon dilatation failure.