Endoscopic management of unresectable malignant gastroduodenal obstruction with a nitinol uncovered metal stent: A prospective Japanese multicenter study

Table 1 Baseline patients and stricture characteristics n (%)

Age, yr, mean ± SD (range)	69.2 ± 13.3 (35-90)
Sex (M/F)	25/14
Primary malignancy,
Gastric cancer	1 (43.6)
Pancreatic cancer	1 (41.0)
Duodenal carcinoma	2 (5.1)
Extrahepatic cholangiocarcinoma	1 (2.6)
Intrahepatic cholangiocarcinoma	1 (2.6)
Ampullary carcinoma	1 (2.6)
Hepatocellular carcinoma (lymph node metastasis)	1 (2.6)
Clinical stage of cancer1
Stage III2	16 (41.0)
Stage IV3	23 (59.0)
Altered gastrointestinal anatomy
Gastroduodenostomy after Billroth I gastrectomy	3 (7.7)
Gastrojejunostomy after Billroth II gastrectomy	1 (2.6)
Gastrojejunostomy after pancreatoduodenectomy	1 (2.6)
Gastrojejunostomy for surgical bypass	1 (2.6)
Location of stricture
Distal stomach	16 (41.0)
Duodenal bulb	4 (10.3)
Second duodenal segment	4 (10.3)
Second/third duodenal segment	4 (10.3)
Third duodenal segment	5 (12.8)
Anastmosis site (gastrostomy)	6 (15.4)
Stricture length, mm, mean ± SD (range)	42.6 ± 19.8 (15-93)
GOOSS score before stent placement
0-no oral intake	16 (41.0)
1-liquid diet	18 (46.2)
2-soft solid diet	5 (12.8)
3-low residue or normal diet	0
WHO perfomance score
0-fully active	7 (17.9)
1-cannot carry out heavy physical work	8 (20.5)
2-up and about > 50% of the day	13 (33.3)
3-up and about < 50% of the day	9 (23.1)
4-bed or chair bound all day	2 (5.1)

¹TNM classification system (ref.);

²Including stage IIIB and IIIC of gastric cancer;

³Including stage IVA of intrahepatic cholangiocarcinoma and hepatocellular carcinoma. GOOSS: Gastric outlet obstruction scoring system; WHO: World Health Organization.

Table 2 Procedure details and study outcomes n (%)

Technical success	39 (100)
Relationship of the papilla and stent placement site
Oral side of the papilla	23 (59.0)
On the papilla	6 (15.4)
Anal side of the papilla	10 (25.6)
Procedure related complication
Aspiration pneumonitis	4 (10.3)
Bleeding 0	0
Perforation 0	0
Cholangitis 0	0
Motality disorder 0	0
Clinical success	36 (92.3)
Additional treatment of malignancy after stent placement
Chemotherapy	15 (38.5)
Chemoradiation	1 (2.6)
Survival after stent placement, d
Median (IQR)	50.0 (25.0-152.0)
mean ± SE	102.9 ± 18.2
Stent patency, d
Median	Not available
mean ± SE	149.6 (7.2)
Stent dysfunction
Stent ingrowth	2 (5.1)
Stent overgrowth	1 (2.6)
Stent compression	0
Stent migration	0
Food impaction	0

IQR: Interquartile range.