悪性胃・十二指腸狭窄に対する内視鏡下stentingの有用性と問題点

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  • SELF-EXPANDABLE METALLIC STENTING FOR MALIGNANT GASTRODUODENAL STENOSIS: EXPERIENCE OF 14 CASES

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Aims: To evaluate the efficacy and limitations of endoscopic placement of self-expandable metallic stents (EMS) in cases of malignant gastroduodenal stenosis. Methods : Fourteen patients who underwent endoscopic placement of EMS for unresectable malignant gastroduodenal stricture were reviewed. Comparison of pre-and post-stenting conditions and evaluation of clinical efficacy were carried out. Results : All procedures were successful. As for food ingestion, 50.0% of the cases showed improvement and the mean dysphagia score changed from 3.5 to 2.6. In 66.7% of the cases that had a stenosis in the upper stomach, improvement of peroral food intake was achieved. However, such intake did not improve even after stenting in all but one patient with stenosis of the distal stomach or proximal duodenum. Conclusions : Use of EMS for unresectable malignant gastroduodenal stenosis is effective in patients with proximal lesions. However, physical patency of the stenosed alimentary tract by stenting is not likely to alleviate the limitation of peroral food intake in patients with distal gastric or proximal duodenal stenosis.

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