Korean Journal of Gastrointestinal Endoscopy 2007;35(4): 221-227.
이중막 구조의 스텐트를 이용한 위암으로 인한 위 배출구 폐쇄의 치료
이수형ㆍ강대환*ㆍ배용목ㆍ최철웅*ㆍ하태인*ㆍ박찬호*ㆍ박형열*ㆍ이선미*ㆍ김광하*ㆍ송근암*
대동병원 내과, *부산대학교 의과대학 내과학교실
Treatment of Gastric Outlet Obstruction by Stomach Cancer with using Double-layered Pyloric Stent
Soo Hyoung Lee, M.D., Dae Hwan Kang, M.D.*, Yong Mock Bae, M.D., Cheul Woong Choi, M.D.*, Tai In Ha, M.D.*, Chan Ho Park, M.D.*, Hyoung Yoel Park, M.D.*, Sun Mi Lee, M.D.*, Gwang Ha Kim, M.D.* and Geun Am Song, M.D.*
Department of Internal Medicine, Daedong Hospital, *Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea
Abstract
Backgroud/Aims: Endoscopic stent placement is widely used to treat an unresectable malignant gastric outlet obstruction. The covered stent has the disadvantage of an increased risk of migration, and the uncovered stent has an increased risk of ingrowth. This study examined the technical and clinical efficiency of stent placement of a double-layered combination pyloric stent that was newly designed to reduce tumor ingrowth and stent migration. Methods: Fifteen patients with a gastric outlet obstruction caused by unresectable stomach cancer were treated with the endoscopic placement of a double-layered combination pyloric stent (an outer uncovered stent to reduce migration and an inner PTEF-covered stent to prevent tumor ingrowth). The technical success, clinical success, and complication especially tumor ingrowth and stent migration were analyzed. Results: Technical success was achieved in 15 out of 15 (100%) patients. Among the 15 patients in whom endoscopic stenting was placed successfully, the clinical success rate was 93.3%, the incidence of tumor ingrowth was 0%, the rate of migration was 6.7%, and tumor overgrowth was observed in 13.3%. The median stent patency period was 105 days. Conclusions: The placement of a double- layered pyloric combination stent appears to be effective in overcoming the disadvantage of the increased migration observed for a covered stent and the increased ingrowth observed for the uncovered stent. (Korean J Gastrointest Endosc 2007;35:221-227)
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