International Journal of Gastrointestinal Intervention

pISSN 2636-0004 eISSN 2636-0012

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< Previous Next >Gastrointestinal Intervention 2016; 5(1): 1~83

Original Article 2016-03-31

Predictors of esophageal self-expandable metal stent migration: An academic center study

Sunguk Jang, Mansour Parsi, James Collins, and John Vargo

https://doi.org/10.18528/gii150018

Abstract : BackgroundAlthough safe and effective, a wide array of complications of esophageal stent placement continues to pose a significant challenge to clinicians in providing optimal care for their patients.MethodsTo identify factors associated with migration of self-expandable metal stent (SEMS) used in treating malignant and benign disease of esophagus, a retrospective study analyzing 105 cases (85 patients) of esophageal SEMS placement between January 2013 and June 2015 was conducted. All cases were performed in a single tertiary referral center. The key outcomes of interest were SEMS migration rates based on indication, stent type, design, and endoscopic findings prior to SEMS placement. Technical success rate, other major adverse outcomes and subgroup analysis of interest were also performed.ResultsOverall esophageal SEMS migration rate was 26.7%. Significantly higher rates of stent migration were associated with fully covered stent use (38.1% vs 9.5%, P = 0.001) and stent use in benign conditions (43.9% vs 15.6%, P = 0.002). Our multivariable analysis also showed statistically significant increased risk of migration for SEMS placement in distal esophagus (P = 0.006).ConclusionThis study validated some of previously reported predictors of stent migration. In addition, stent use in benign esophageal disease was found to be a significant risk factor of SEMS migration. Large, prospective studies are necessary to further clarify modifiable risk factors to reduce the rate of SEMS migration.

Cited By: 3

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Case Report 2016-03-31

Percutaneous transgastric stenting of proximal jejunal obstruction secondary to direct invasion of a pancreatic carcinoma

Timothy Joseph S. Orillaza, Jinoo Kim, and Je Hwan Won

https://doi.org/10.18528/gii150033

Abstract : Pancreatic cancer has been identified as one of the most common malignant causes of upper gastrointestinal obstruction. Most common sites of obstruction include the pyloric region and second and third portions of the duodenum. If surgical gastrojejunostomy is not a viable option, metallic stent placement may be performed either by transoral or transgastric approach. Transgastric technique is considered to be more invasive and is often employed only in failed attempts to insert a stent using transoral technique. This report presents a 70-year-old patient with pancreatic cancer involving the proximal jejunum. Although this is a rarely described location for stenting, the patient was successfully treated using transgastric technique.

Cited By: 2

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