Duodenal obstruction caused by pancreatic head carcinoma: palliation with self-expandable endoprostheses

Background: The risks of palliative operative intervention of gastric outlet obstruction for advanced pancreatic head carcinoma has been reported to be quite high. The present study reports the results of attempted endoscopic palliation of duodenal obstruction in these patients. Methods: Ten patients with endoscopically documented malignant duodenal strictures from pancreatic head carcinoma in whom self-expandable endoprostheses were placed are retrospectively analyzed. In three patients with jaundice, biliary stents were also placed. Standard esophageal type (not membrane coated) Wallstent self-expandable endoprostheses were used. Patients: Gastric outlet obstruction was relieved in all patients after implantation of duodenal endoprostheses, and jaundice was palliated in those with additional biliary obstruction after bile duct stenting. One case of gastric ulceration was the major complication. No recurrence of gastric outlet obstruction was noted in the follow-up period of 1 to 5 months. Conclusion: The preliminary data suggest that self-expandable duodenal endoprostheses can effectively relieve gastric outlet obstruction in patients with advanced pancreatic head carcinoma.