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DOI:10.2214/AJR.08.1760
AJR 2009; 193:241-247
© American Roentgen Ray Society

Original Research

Metallic Stent Placement in the Palliative Treatment of Malignant Gastric Outlet Obstructions: Primary Gastric Carcinoma Versus Pancreatic Carcinoma

Jin Hyoung Kim1, Ho-Young Song1, Ji Hoon Shin1, Hong Tao Hu1, Sung Koo Lee2, Hwoon-Yong Jung2 and Jeong Hwan Yook3

1 Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-2dong, Songpa-gu, Seoul 138-736, Korea.
2 Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
3 Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

OBJECTIVE. The objective of our study was to compare the clinical effectiveness of metallic stent placement for relief of gastric outlet obstruction caused by gastric carcinoma and pancreatic carcinoma.

MATERIALS AND METHODS. A total of 207 patients with gastric outlet obstruction caused by inoperable gastric carcinoma (n = 147) or pancreatic carcinoma (n = 60) underwent metallic stent placement.

RESULTS. Technical success of metallic stent placement was achieved in all patients. Clinical success was achieved in 97% and 93% of patients with gastric and pancreatic carcinoma, respectively (p = 0.286). The overall complication rate did not differ significantly between the gastric (29%) and pancreatic (23%) carcinoma groups (p = 0.441). Stent collapse was significantly more frequent in the gastric carcinoma group (11%) than the pancreatic carcinoma group (2%) (p = 0.027), whereas serious complications, including gastrointestinal bleeding and intestinal perforation, occurred more frequently in the pancreatic (7%) than the gastric (1%) carcinoma group (p = 0.026). The cumulative survival period was significantly longer in the gastric carcinoma (median, 153 days) than the pancreatic carcinoma (median, 90 days) group (p = 0.041), but cumulative stent patency did not differ significantly between the gastric carcinoma (median, 350 days) and pancreatic carcinoma (median, 385 days) groups (p = 0.415).

CONCLUSION. Metallic stent placement was clinically effective in the palliative treatment of gastric outlet obstruction in patients with gastric and pancreatic carcinoma. The two groups differed significantly in the rates of stent collapse and serious complications and patient survival after stent placement.

Keywords: gastric carcinoma • gastric outlet obstruction • oncologic imaging • pancreatic carcinoma • stents


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