Original ArticlePalliation of patients with malignant gastric outlet obstruction with the enteral Wallstent: outcomes from a multicenter study
Section snippets
Patients and methods
A cohort of patients who had undergone enteral stent placement for malignant gastric outlet obstruction was constructed from patients seen at 4 endoscopic referral centers: Brigham and Women's Hospital, Boston, Massachusetts (1993-2003), Mayo Clinic, Rochester, Minnesota (1998-2002), Catholic University, Rome, Italy (1996-2002), and Northwestern University, Chicago, Illinois (1999-2002). Twenty-nine of 68 patients from the Brigham and Women's Hospital and 35 of 43 patients from the Mayo Clinic
Results
A total of 176 patients (56% men, mean age 65 [14] years) meeting the inclusion criteria were identified at the 4 sites. Obstruction was caused by pancreatic cancer in 84 (48%) patients, metastases in 33 (19%), gastric cancer in 20 (11%), cholangiocarcinoma in 15 (8%), cancer of the papilla in 8 (5%), gallbladder cancer in 4 (2%), and another type of malignancy in 12 (7%). The site of obstruction was the duodenum in 125 (71%), the distal stomach in 17 (10%), both the stomach and the duodenum in
Discussion
The ability of a patient to eat is determined by appetite and the functional status of the GI tract. Appetite is affected by mood, symptoms, functional status, and tumor burden.15 Normal motility is required for the GI tract to function. Motility is affected by peritoneal carcinomatosis, long-standing obstruction, and patency. Although many factors other than enteral stent obstruction may cause or contribute to cessation of oral intake in the patient population with malignant disease, oral
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This work was presented in part at the annual meeting of the American Society of Gastrointestinal Endoscopy, May 18-21, 2003, Orlando, Florida (Gastrointest Endosc 2003;57:AB116).