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Digestive Diseases and Sciences

, Volume 63, Issue 12, pp 3409–3416 | Cite as

Winged Partially Covered Self-Expandable Metal Stent to Prevent Distal Migration in Malignant Gastric Outlet Obstruction

  • Young Kwon Choi
  • Ji Yong AhnEmail author
  • Hee Kyong Na
  • Kee Wook Jung
  • Do Hoon Kim
  • Jeong Hoon Lee
  • Kee Don Choi
  • Ho June Song
  • Gin Hyug Lee
  • Hwoon-Yong Jung
Original Article
  • 127 Downloads

Abstract

Background

Through-the-scope implantation of self-expandable metal stents can be used for the palliation of malignant gastric outlet obstruction. Although covered stents were developed to prevent tumor ingrowth, often seen with uncovered stents, migration is still a major problem. Especially, surgical treatment is required for some patients if distal migration occurs.

Aims

To evaluate the usefulness of the newly designed winged stent that was developed to prevent distal stent migration.

Methods

This was a single-center, single-arm, retrospective study. A total of 63 inoperable cancer patients with symptomatic gastric outlet obstruction were reviewed to evaluate the safety and efficacy of a newly designed partially covered self-expandable metal stent with star-shaped wing flaps at the proximal end to reduce distal stent migration.

Results

Technical and clinical successes were achieved in 100% and 87.3% of patients, respectively. The gastric outlet obstruction scoring system score significantly improved after stent placement (from median 1 to 2, P < 0.001). The median duration of stent patency was 147 days (interquartile range 76–201), and median duration of overall survival was 176 days (interquartile range 79–325). Stent migration was observed in seven patients (11.1%), and restenosis was developed in 12 patients (19.0%). All cases of migration were proximal, and no distal migration was observed. Endoscopic removal of migrated stents was performed successfully in all cases.

Conclusions

The newly designed winged stent showed feasible efficacy and safety for malignant gastric outlet obstruction. Furthermore, it effectively prevented distal stent migration.

Keywords

Gastric outlet obstruction Self-expandable metallic stents Stomach neoplasms Pancreatic neoplasms Cholangiocarcinoma Gallbladder neoplasms 

Notes

Compliance with ethical standards

Conflict of Interest

The entire team of authors Drs. Young Kwon Choi, Ji Yong Ahn, Hee Kyong Na, Kee Wook Jung, Do Hoon Kim, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Gin Hyug Lee, and Hwoon-Yong Jung have no conflicts of interest or financial ties to disclose.

Supplementary material

10620_2018_5284_MOESM1_ESM.docx (16 kb)
Supplementary material 1 (DOCX 15 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Young Kwon Choi
    • 1
  • Ji Yong Ahn
    • 1
    Email author
  • Hee Kyong Na
    • 1
  • Kee Wook Jung
    • 1
  • Do Hoon Kim
    • 1
  • Jeong Hoon Lee
    • 1
  • Kee Don Choi
    • 1
  • Ho June Song
    • 1
  • Gin Hyug Lee
    • 1
  • Hwoon-Yong Jung
    • 1
  1. 1.Department of GastroenterologyUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulKorea

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