La Radiologia medica · 2011
An integrated, self-expanding, Y-shaped, metallic stent for patients with complex obstruction after gastrojejunostomy (Billroth II): initial experience.
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Wu G, Li Y-D, Han X-W, Ding P-X
Аннотация
PURPOSE: This paper reports our initial experience with an integrated, self-expandable, Y-shaped, metallic stent (SEMS) for patients with complex anastomotic obstructions after gastrojejunostomy (Billroth II).
MATERIALS AND METHODS: Eight consecutive patients with complex anastomotic obstructions involving the afferent and efferent loops after gastrojejunostomy (Billroth II) were treated with an integrated Y-shaped SEMS. The stents were placed in the anastomosis under fluoroscopy. Technical and clinical success; complications, including recurrent obstruction and stent migration; reintervention; and survival were assessed during follow-up.
RESULTS: Y-shaped SEMS placement in the anastomotic areas was technically successful and well tolerated in all patients, with no procedure-related complications. Clinical success was observed in all patients 1-7 days after the procedure. The improvement between pre- and postoperative gastric outlet obstruction scoring system (GOOSS) was statistically significant (p=0.01). During follow-up for 3.13 ± 1.81 months, all stenoses were resolved without stent-related complications, and general physical examination of the eight patents showed improvement. Five patients continued with follow-up health care after the procedures; the remaining three died of causes unrelated to stent insertion. The mean and median survival periods were 3.92 ± 0.81 months [95% confidence interval (CI) 2.34-5.50] and 3.0 ± 0.64 months (95% CI 1.74-4.26), respectively.
CONCLUSIONS: Deployment of an integrated Y-shaped SEMS proved to be an expedient, simple, safe and minimally invasive procedure for treating complex anastomotic stenoses after gastrojejunostomy (Billroth II).
MATERIALS AND METHODS: Eight consecutive patients with complex anastomotic obstructions involving the afferent and efferent loops after gastrojejunostomy (Billroth II) were treated with an integrated Y-shaped SEMS. The stents were placed in the anastomosis under fluoroscopy. Technical and clinical success; complications, including recurrent obstruction and stent migration; reintervention; and survival were assessed during follow-up.
RESULTS: Y-shaped SEMS placement in the anastomotic areas was technically successful and well tolerated in all patients, with no procedure-related complications. Clinical success was observed in all patients 1-7 days after the procedure. The improvement between pre- and postoperative gastric outlet obstruction scoring system (GOOSS) was statistically significant (p=0.01). During follow-up for 3.13 ± 1.81 months, all stenoses were resolved without stent-related complications, and general physical examination of the eight patents showed improvement. Five patients continued with follow-up health care after the procedures; the remaining three died of causes unrelated to stent insertion. The mean and median survival periods were 3.92 ± 0.81 months [95% confidence interval (CI) 2.34-5.50] and 3.0 ± 0.64 months (95% CI 1.74-4.26), respectively.
CONCLUSIONS: Deployment of an integrated Y-shaped SEMS proved to be an expedient, simple, safe and minimally invasive procedure for treating complex anastomotic stenoses after gastrojejunostomy (Billroth II).