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Minerva Chirurgica 2014 Dec 17

lingua: Inglese

Application of the catheter and guidewire transmission technology in reconstruction of gastroduodenal malignant stricture

Li D. 1, Li R. 2, Lv X. 3, Tian Q. 4, Sun S. 5

1 Affiliated Xuzhou Hospital, Radiology department, Southeast University Medical College, Xuzhou, China;
2 Affiliated Xuzhou Hospital, Nutrition department, Southeast University Medical College, Xuzhou, China;
3 Affiliated Xuzhou Hospital, Gastrointestinal surgical department, Southeast University Medical College, Xuzhou, China;
4 Affiliated Xuzhou Hospital, Oncological surgery, Southeast University Medical College, Xuzhou, China;
5 Affiliated Xuzhou Hospital, Medical oncology, Southeast University Medical College, Xuzhou, China


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AIMS: Gastroduodenal obstruction is a preterminal event in patients with advanced and recurrent malignancies of the stomach, pancreas, and duodenum. It severely limits the quality of life in affected patients due to constant vomiting and associated malnutrition. Gastroduodenal stent placement is a very safe and effective method in patients with unresectable malignant tumors.
METHODS: Thirty-­six patients with malignant gastroduodenal stenosis accompanied by gastrointestinal obstruction which was not traversable with gastroscope were included in the study. Under X-­ray monitoring, the catheter was inserted through stenosis by alternating advancing with loach guidewire which was later replaced by a stiff guidewire. Then, a tri-­lumen gastrojejunal catheter was introduced using the stiff guidewire through the stenosis to perform gastrointestinal decompression and provide intestinal nutrition. In some patients, intestinal stent was placed at the site of the stenosis.
RESULTS: In all 36 patients, 35 achieved successful intubation. A total of 12 intestinal stents were successfully placed, including 2 at pylorus, 6 at the site of gastrointestinal anastomosis and 4 at the descending and horizontal part of duodenum.
CONCLUSION: Establishment of enteral nutrition via intubation using guidewire and cather delivery technology is a simple, effective and safe strategy for the patients with gastriscopic inaccessible malignant gastrodoudenal stenosis and recommended in hospital practice.

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lidechun7878@sina.com