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Endoscopic Stenting for Gastric Outlet Obstruction

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Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy

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Abstract

Malignant gastric outlet obstruction (MGOO) is a late complication of advanced malignancies either from gastrointestinal cancers or external compression outside the lumen. Self-expandable metal stent (SEMS) placement used to be an option for the palliation of MGOO and has become the mainstream management. It provides several advantages over surgical bypass including earlier oral intake, rapid symptom relief, less invasiveness, and shorter hospital stays. Although SEMS placement is a safe and effective management for MGOO; however, stent dysfunctions with obstruction or migration limit the utilization and increase reintervention rates. Some modified designs of stents have been developed to solve the problems, but the results are still not satisfactory. Further modifications of stents are still warranted.

Benign gastric outlet obstruction is mainly caused by peptic ulcer disease. Endoscopic balloon dilatation (EBD) is still the main management, and surgery is the last resort for the patients refractory to repeated balloon dilation. The role of SEMS placement for benign GOO is limited. Lumen-apposing metal stent (LAMS) placement is an alternative and suitable for short bowel strictures. The studies comparing the outcome of EBD, LAMS, and SEMS placement are needed.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Taiwan Adventist Hospital, Taipei, Taiwan

    Bing-Wei Ye

  2. Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Bing-Wei Ye & Kuei-Chuan Lee

  3. Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan

    Bing-Wei Ye & Kuei-Chuan Lee

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  1. Bing-Wei Ye
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Correspondence to Kuei-Chuan Lee .

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Editors and Affiliations

  1. Division of Gastroenterology and Gastrointestinal Endoscopy IRCCS, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy

    Pier Alberto Testoni

  2. Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan

    Haruhiro Inoue

  3. Department of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, FL, USA

    Michael B. Wallace

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  1. Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA

    Michael B. Wallace

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Ye, BW., Lee, KC. (2022). Endoscopic Stenting for Gastric Outlet Obstruction. In: Testoni, P.A., Inoue, H., Wallace, M.B. (eds) Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-56993-8_54

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